New estimates suggest that 20 to 30 percent of opioid analgesic drugs prescribed for chronic pain are misused, while the rate of opioid addiction is approximately 10 percent, reports a study in the April issue of Pain, the official journal of the International Association for the Study of Pain.
"On average, misuse was documented in approximately one out of four or five patients and addiction in approximately one out of ten or eleven patients," who were prescribed opioids as part of their treatment for chronic pain, writes Kevin E. Vowles, PhD, of University of New Mexico (UNM), Albuquerque, and colleagues. The researchers note extremely wide variation in reported rates of misuse, abuse, and addiction and raise questions about the benefits of widespread opioid use for chronic pain, given the harmful consequences.
Study Provides New Estimates of Opioid Misuse and Addiction...
Dr. Vowles and coauthors reviewed published studies to produce "updated and expanded" estimates of rates of problem opioid use. Prescribing of these powerful pain-relieving drugs has skyrocketed in the past 15 years. This sharp increase has coincided with an increase in opioid-related problems, such as dependence, withdrawal, and overdose. The study was funded by a grant from the Center for Health Policy at the Robert Wood Johnson Foundation Center for Health Policy at UNM.
Estimates were calculated using data from 38 reports, with adjustments for study sample size, quality, and methods. Three specific types of problem opioid use were recorded: misuse, abuse, and addiction. The study found very high variability in specific rates of opioid misuse and addiction identified across different studies—ranging from less than 1 percent to more than 80 percent.
On adjusted analysis, the average rate of opioid misuse was estimated at 21 to 29 percent. Misuse was defined as using opioids contrary to instructions, regardless of harmful or adverse effects.
Adjusted average rates of opioid addiction—defined as continued opioid use with actual or potential harmful effects—ranged from 8 to 12 percent. Only one study analyzed the rate of opioid abuse: intentionally using the drugs for nonmedical purposes.
...With Insights into "Clinical Reality'" of Opioids for Chronic Pain
Reported rates of opioid addiction were lower for studies with a "primary focus" on this issue. Otherwise, studies with different characteristics yielded comparable rates of problem opioid use.
Amid the ongoing "opioid epidemic," the new review provides informed estimates of specific types of problem opioid use. The researchers call for further research, including relevant information on patient and pain-related characteristics and focusing on specific types of problematic opioid use. Such studies are needed to provide accurate data for clinicians and policymakers to make sound decisions.
Dr. Vowles and colleagues draw special attention to the high rate of opioid misuse. They write, "If it is accurate that approximately one in four patients on opioids display patterns of opioid misuse, but not addiction, then perhaps more efficient targeting of treatment resources would be of benefit." For example, even low-intensity interventions, such as patient education and monitoring, might be a viable alternative to simply not prescribing the medications for those at risk of misuse.
The researchers also note that 35 of the 38 studies reviewed were conducted in the United States. This "curious finding...suggests that this issue is of both high interest and is perhaps a problem that is somehow uniquely relevant to the US," they write.
Dr. Vowles and coauthors discuss the documented rates of opioid misuse and addiction in light of the "clinical reality of chronic pain treatment." They conclude, "We are not certain that the benefits derived from opioids, which are rather unclear...compensate for this additional burden to patients and health-care systems."
Explore further: Medical field urged to look within for solution to opioid addiction
More information: "Running Head: Opioid Misuse, Abuse, AND Addiction" DOI: 10.1097/01.j.pain.0000460357.01998.f1
Medical Xpress on facebook
Related Stories
Medical field urged to look within for solution to opioid addiction
University of Cincinnati (UC) researchers are asking the medical community to consider its own role in the rise in prescription opioid abuse, calling for more research on iatrogenic addiction (addiction resulting from medical ...
Opioid and heroin crisis triggered by doctors overprescribing painkillers
According to researchers at Brandeis University, the University of North Florida and Johns Hopkins University, policymakers must look beyond painkiller abuse, also called non-medical use, in their efforts to reduce opioid ...
Research shows 25 percent fewer opioid-related deaths in states allowing medical marijuana
On average, states allowing the medical use of marijuana have lower rates of deaths resulting from opioid analgesic overdoses than states without such laws. Opioid analgesics, such as OxyContin, Percocet and Vicodin, are ...
NIH: Insufficient evidence for opioid use in chronic pain
(HealthDay)—Evidence is insufficient for opioid use in chronic pain, according to a position paper published online Jan. 13 in the Annals of Internal Medicine.
Scientist finds higher opioid doses associated with increase in depression
Patients who increased doses of opioid medicines to manage chronic pain were more likely to experience an increase in depression, according to Saint Louis University findings in Pain.
Recommended for you
UnitedHealth bulks up for prescription drug cost battle (Update)
The nation's largest health insurer, UnitedHealth, will muscle up for its fight against rising prescription drug costs by spending more than $12 billion to buy pharmacy benefits manager Catamaran Corp.
Teva buying Auspex for $3.2 billion
Teva Pharmaceutical Industries Ltd. is buying Auspex Pharmaceuticals Inc. for about $3.2 billion in a move to strengthen its position on central nervous system condition treatments.
Oral hepatitis B vaccine could become a reality
In a new study, researchers report progress toward perfecting a radical new method of producing vaccines using genetically modified corn. The approach could lead to an oral hepatitis B vaccine that requires no refrigeration ...
Britain to offer all infants meningitis B vaccine
Britain says it will become the first country to offer all babies a vaccine for potentially fatal meningitis B after it reached a price deal with GlaxoSmithKline PLC.
US aims to cut antibiotic use
US President Barack Obama on Friday rolled out plans to cut inappropriate antibiotic use by half, in an effort to tackle drug resistance.
Ebola whole virus vaccine shown effective, safe in primates
An Ebola whole virus vaccine, constructed using a novel experimental platform, has been shown to effectively protect monkeys exposed to the often fatal virus.
User comments
Please sign in to add a comment. Registration is free, and takes less than a minute. Read more
Click here to reset your password.
Sign in to get notified via email when new comments are made.
New estimates suggest that 20 to 30 percent of opioid analgesic drugs prescribed for chronic pain are misused, while the rate of opioid addiction is approximately 10 percent, reports a study in the April issue of Pain, the official journal of the International Association for the Study of Pain.
"On average, misuse was documented in approximately one out of four or five patients and addiction in approximately one out of ten or eleven patients," who were prescribed opioids as part of their treatment for chronic pain, writes Kevin E. Vowles, PhD, of University of New Mexico (UNM), Albuquerque, and colleagues. The researchers note extremely wide variation in reported rates of misuse, abuse, and addiction and raise questions about the benefits of widespread opioid use for chronic pain, given the harmful consequences.
Study Provides New Estimates of Opioid Misuse and Addiction...
Dr. Vowles and coauthors reviewed published studies to produce "updated and expanded" estimates of rates of problem opioid use. Prescribing of these powerful pain-relieving drugs has skyrocketed in the past 15 years. This sharp increase has coincided with an increase in opioid-related problems, such as dependence, withdrawal, and overdose. The study was funded by a grant from the Center for Health Policy at the Robert Wood Johnson Foundation Center for Health Policy at UNM.
Estimates were calculated using data from 38 reports, with adjustments for study sample size, quality, and methods. Three specific types of problem opioid use were recorded: misuse, abuse, and addiction. The study found very high variability in specific rates of opioid misuse and addiction identified across different studies—ranging from less than 1 percent to more than 80 percent.
On adjusted analysis, the average rate of opioid misuse was estimated at 21 to 29 percent. Misuse was defined as using opioids contrary to instructions, regardless of harmful or adverse effects.
Adjusted average rates of opioid addiction—defined as continued opioid use with actual or potential harmful effects—ranged from 8 to 12 percent. Only one study analyzed the rate of opioid abuse: intentionally using the drugs for nonmedical purposes.
...With Insights into "Clinical Reality'" of Opioids for Chronic Pain
Reported rates of opioid addiction were lower for studies with a "primary focus" on this issue. Otherwise, studies with different characteristics yielded comparable rates of problem opioid use.
Amid the ongoing "opioid epidemic," the new review provides informed estimates of specific types of problem opioid use. The researchers call for further research, including relevant information on patient and pain-related characteristics and focusing on specific types of problematic opioid use. Such studies are needed to provide accurate data for clinicians and policymakers to make sound decisions.
Dr. Vowles and colleagues draw special attention to the high rate of opioid misuse. They write, "If it is accurate that approximately one in four patients on opioids display patterns of opioid misuse, but not addiction, then perhaps more efficient targeting of treatment resources would be of benefit." For example, even low-intensity interventions, such as patient education and monitoring, might be a viable alternative to simply not prescribing the medications for those at risk of misuse.
The researchers also note that 35 of the 38 studies reviewed were conducted in the United States. This "curious finding...suggests that this issue is of both high interest and is perhaps a problem that is somehow uniquely relevant to the US," they write.
Dr. Vowles and coauthors discuss the documented rates of opioid misuse and addiction in light of the "clinical reality of chronic pain treatment." They conclude, "We are not certain that the benefits derived from opioids, which are rather unclear...compensate for this additional burden to patients and health-care systems."
Explore further: Medical field urged to look within for solution to opioid addiction
More information: "Running Head: Opioid Misuse, Abuse, AND Addiction" DOI: 10.1097/01.j.pain.0000460357.01998.f1
Medical Xpress on facebook
Related Stories
Medical field urged to look within for solution to opioid addiction
University of Cincinnati (UC) researchers are asking the medical community to consider its own role in the rise in prescription opioid abuse, calling for more research on iatrogenic addiction (addiction resulting from medical ...
Opioid and heroin crisis triggered by doctors overprescribing painkillers
According to researchers at Brandeis University, the University of North Florida and Johns Hopkins University, policymakers must look beyond painkiller abuse, also called non-medical use, in their efforts to reduce opioid ...
Research shows 25 percent fewer opioid-related deaths in states allowing medical marijuana
On average, states allowing the medical use of marijuana have lower rates of deaths resulting from opioid analgesic overdoses than states without such laws. Opioid analgesics, such as OxyContin, Percocet and Vicodin, are ...
NIH: Insufficient evidence for opioid use in chronic pain
(HealthDay)—Evidence is insufficient for opioid use in chronic pain, according to a position paper published online Jan. 13 in the Annals of Internal Medicine.
Scientist finds higher opioid doses associated with increase in depression
Patients who increased doses of opioid medicines to manage chronic pain were more likely to experience an increase in depression, according to Saint Louis University findings in Pain.
Recommended for you
UnitedHealth bulks up for prescription drug cost battle (Update)
The nation's largest health insurer, UnitedHealth, will muscle up for its fight against rising prescription drug costs by spending more than $12 billion to buy pharmacy benefits manager Catamaran Corp.
Teva buying Auspex for $3.2 billion
Teva Pharmaceutical Industries Ltd. is buying Auspex Pharmaceuticals Inc. for about $3.2 billion in a move to strengthen its position on central nervous system condition treatments.
Oral hepatitis B vaccine could become a reality
In a new study, researchers report progress toward perfecting a radical new method of producing vaccines using genetically modified corn. The approach could lead to an oral hepatitis B vaccine that requires no refrigeration ...
Britain to offer all infants meningitis B vaccine
Britain says it will become the first country to offer all babies a vaccine for potentially fatal meningitis B after it reached a price deal with GlaxoSmithKline PLC.
US aims to cut antibiotic use
US President Barack Obama on Friday rolled out plans to cut inappropriate antibiotic use by half, in an effort to tackle drug resistance.
Ebola whole virus vaccine shown effective, safe in primates
An Ebola whole virus vaccine, constructed using a novel experimental platform, has been shown to effectively protect monkeys exposed to the often fatal virus.
User comments
Please sign in to add a comment. Registration is free, and takes less than a minute. Read more
Click here
to reset your password.
Sign in to get notified via email when new comments are made.
0 comments:
Post a Comment