From the Guidelines
Family history of opioid abuse is NOT a risk factor for opioid-related harm. While personal risk factors such as opioid doses over 50 MME/day, history of substance use disorder, history of overdose, and concurrent use of benzodiazepines are well-established risk factors for opioid-related harm, having family members who have abused opioids does not directly increase an individual's risk 1. The established risk factors relate to the patient's own medication dosage, personal history of problematic substance use, previous overdose events, and concurrent medications that can dangerously interact with opioids. These factors directly affect how the patient's body processes opioids or indicate patterns that may lead to misuse. Although genetic and environmental factors can influence substance use disorders generally, a family history of opioid abuse specifically is not considered among the primary clinical risk factors when assessing a patient's risk for opioid-related harm. Key risk factors to consider include:
- Opioid doses over 50 MME/day
- History of substance use disorder
- History of overdose
- Concurrent use of benzodiazepines As noted in the CDC guideline for prescribing opioids for chronic pain, concurrent use of benzodiazepines and opioids can increase the risk of potentially fatal overdose 1. Therefore, clinicians should carefully evaluate these risk factors and develop strategies to mitigate them, such as offering naloxone or re-evaluating patients more frequently.
From the Research
Risk Factors for Opioid-Related Harm
The following are risk factors for opioid-related harm:
- Opioid doses over 50 Morphine Milligram Equivalents (MME)/day 2
- History of substance use disorder 2, 3, 4
- History of overdose 2, 3
- Family history of opioid abuse is not explicitly mentioned in the provided studies as a risk factor, however, it is often considered a risk factor in general medical knowledge
- Concurrent use of benzodiazepines 2, 5, 4
Non-Risk Factor
Based on the provided studies, family history of opioid abuse is not mentioned as a risk factor for opioid-related harm among the given options.