One in 4 Patients Prescribed Opioids Will Move to Long-Term Use

Weighing the pros and cons of prescription opioid use for chronic pain is an ongoing battle, and new research may have just added to the list of disadvantages.

Nearly 25% of patients with an opioid prescription will end up using the drugs long-term. This finding comes on the heels of a recent study that revealed physicians do not understand the scope of the prescription pain medication problem in the US. Lead author W. Michael Hooten, MD, and colleagues from the Mayo Clinic explained how they made this discovery and what can be done to reduce the number of people on chronic opioid therapy.

“Many people will suggest it’s actually a national epidemic,” Hooten, an anesthesiologist at Mayo Clinic, said in a news release. “More people now are experiencing fatal overdoses related to opioid use than compared to heroin and cocaine combined.”

The researchers randomly selected 293 patients from the Rochester Epidemiology Project who had a new prescription for opioids in 2009. They tracked the participants’ opioid prescription patterns over the next year and classified their usage as short-term, episodic, or long-term.

During that one year, 515 new opioid prescriptions were written for the 293 patients. According to the data published in Mayo Clinic Proceedings, 61 patients (21%) progressed from short-term use to episodic use (lasting between 3 and 4 months). The authors reported 19 patients (6%) moved to long-term patterns (lasting more than 4 months).

There was a significant linkage between substance abuse and episodic or long-term opioid prescribing patterns. Past or current nicotine use was also associated with the additional prescriptions. Hooten explained that this connection is credited to neurobiology, which suggests similarities between chronic pain, opioid use, and addiction.

Although physicians hold the prescription pads, patients should be aware of the risks involved with opioids and alternative non-narcotic options.

“I encourage use of alternative methods to manage pain, including non-opioid analgesics or other nonmedication approaches,” Hooten said. “That reduces or even eliminates the risk of these medications transitioning to another problem that was never intended.”

For the next step in their research, the team plans to study how the dose and quantity of opioid prescribed plays a part in addiction and overdoses.

“It is possible that higher dose or greater quantities of the drug with each prescription are important predictors of longer-term use,” Hooten concluded.