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Annals of Internal Medicine tip sheet for Jan. 19, 2010, issue
Date:1/18/2010

1. Prescribed Opioids Associated with Significant Risk for Overdose

Prescriptions of some opioids, such as oxycodone, have increased significantly over the past decade. As long-term opioid therapy for chronic noncancer pain becomes more common, the deaths associated with opioids increase. Opioid overdose is among the most common causes of death nationwide. Researchers sought to determine the rate of opioid overdose in relation to an average prescribed daily opioid dose among patients receiving medically-prescribed, long-term opioid therapy. Researchers observed 9,940 adults receiving at least three opioid prescriptions for chronic noncancer pain within 90 days. Fifty-one of the 9,940 adults receiving long-term opioid therapy had one or more overdose events during follow-up. Six of those events were fatal. Most of the observed overdoses occurred in patients receiving lower opioid doses although risks for overdoses increased for patients receiving higher doses. Due to uncertainties regarding effectiveness and the risk for overdose, long-term opioid therapy should be prescribed carefully for noncancer pain. Researchers recommend that physicians closely monitor opioid patients, dose judiciously, and continually reevaluate the benefit of the drugs. A. Thomas McLellan, PhD., author of an editorial on the study and Deputy Director of the White House Office of National Drug Control Policy states, "The threat to patient safety is too great to allow current pain management and opioid prescribing practices to remain as they are."

2. Leptin Therapy Could Hold Key to Long-term Weight Loss

Hormone Helps to Regulate Energy Homeostasis, Neuroendocrine Function, and Metabolism

Leptin is a hormone that plays a central role in fat metabolism. Patients with genetic leptin deficiency are obese, and treatment with leptin leads to dramatic weight loss through decreased food intake and possible increased energy expenditure. H
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Contact: Angela Collom
acollom@acponline.org
215-351-2653
American College of Physicians
Source:Eurekalert

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