Quarter of patients prescribed opioids progress to long-term use

One quarter of patients prescribed opioid painkillers for the first time progress to long-term use of these medications, according to researchers at the Mayo Clinic.

The findings were published in the July issue of Mayo Clinic Proceedings. The findings also show that patients with histories of tobacco use and substance abuse were most likely to graduate to long-term use of opioid painkillers.

Doctor dispensing linked to unnecessary opioid Rxs

“From a patient perspective, it is important to recognize the potential risks associated with these medications. I encourage use of alternative methods to manage pain, including non-opioid analgesics or other non-medication approaches,” said W. Michael Hooten, MD,  lead study author and an anesthesiologist at Mayo Clinic in Rochester, Minn. “That reduces or even eliminates the risk of these medications transitioning to another problem that was never intended.”

Hooten said while it is important for healthcare providers to identify patients who are more likely to abuse opioid painkillers, all patients should proceed cautiously when offered opioid painkillers. “Many people will suggest it’s actually a national epidemic. More people now are experiencing fatal overdoses related to opioid use than compared to heroin and cocaine combined.” 

The Mayo researchers analyzed the records of 293 patients who in 2009 received a new prescription for painkillers such as oxycodone, morphine, hydromorphone, oxymorphone, hydrocodone, fentanyl, meperidine, codeine, and methadone.

Researchers found that 21% of the patients went from a single prescription to prescriptions lasting three to four months. Six percent of the patients ended up with more than a four-month supply of the painkillers.

Hooten said long-term use of opioids might make patients more sensitive to pain. He said when opioids must be used, it is important to reduce the dose and limit the duration. “The next step in this research is to drill down and find more detailed information about the potential role of dose and quantity of medication prescribed,”  Hooten said. “It is possible that higher dose or greater quantities of the drug with each prescription are important predictors of longer-term use.”