Chronic pain meds misused by 20% to 25% of patients

Approximately 20 to 25 percent of patients using opioids for chronic pain have misused these drugs, according to a report published in the journal Pain.

In addition, 9 to 10 percent of patients taking opioid painkillers for chronic relief had developed an addiction to the medications, according to Kevin E. Vowles, of the department of psychology at the University of New Mexico, Albuquerque, and his co-authors.

The authors had reviewed data from 38 published studies, and of these 76% noted misuse and 32% noted addiction with the chronic use of opioids.

“The results of this review have 2 key implications,” explained Vowles and his colleagues. “First, misuse and addiction do seem to be distinct patterns of problematic opioid use…. Second, misuse seems to be more common than addiction.”

Problematic misuse

Misuse seen in the studies included inappropriate use, such as use for anxiety or other distress; erratic/disorganized/underuse; use with alcohol or marijuana; and overuse.

For those patients who misuse opioids, the authors suggested that targeted treatment would be of benefit, such as education and frequent follow-up visits with a healthcare provider. A 2010 study in Pain indicated that monthly meetings for six months were useful and included education about opioids, motivational approaches, and monitoring of opioid use. Low rates of aberrant behavior were noted at the end of study.

“These findings suggest that there are alternatives available to providers who treat high-risk patients beyond simply not prescribing the medications at all,” according to Vowles and his colleagues.

Recommendations for future studies

The authors made several recommendations for future studies of problematic opioid use for patients using these drugs long-term.

            *Include relevant demographic and pain-related information, such as gender, age, ethnicity, pain location, and length of pain suffering.

            *Include type of problematic use of opioids.

            *Consider using the Aberrant Drug Behavior Index to identify misuse, abuse, and addiction to opioids.

Also, see:

DEA to scrutinize hospital pharmacists for opioid monitoring

FDA: Final guidance on evaluation, labeling of abuse-deterrent opioids