Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Dual Receipt of Rx Opioids & Overdose Death

Ann Intern Med; ePub 2019 Mar 12; Moyo, et al

Among veterans enrolled in both the US Department of Veterans Affairs (VA) and Medicare Part D, dual use of opioid prescriptions was independently associated with death from prescription opioid overdose. This according to a nested case-control study in which 215 case patients who died of a prescription opioid overdose in 2012 or 2013 were matched 1:4 with 833 living control patients by date of death (index date). The primary outcome was unintentional or undetermined-intent death from prescription opioid overdose. Researchers found:

  • Among case patients, mean age was 57.3 years, 194 (90%) were male, and 181 (84%) were non-Hispanic white.
  • 60 case patients (28%) and 117 control patients (14%) received dual opioid prescriptions.
  • Dual users had significantly higher odds of death from prescription opioid overdose vs those receiving opioids from VA only or Part D only.


Moyo P, Zhao X, Thorpe CT, et al. Dual receipt of prescriptions opioids from the Department of Veterans Affairs and Medicare Part D and prescription opioid overdose death among veterans: A nested case-control study. [Published online ahead of print March 12, 2019]. Ann Intern Med. doi:10.7326/M18-2574.