Two medical studies released this week regarding opioid use point to risks.
Researchers at the Mayo Clinic say that one in four people prescribed an opioid painkiller progressed to longer term prescriptions. People who were tobacco users and substance abusers were likeliest to use opioids long term.
The findings were published in the medical journal Mayo Clinic Proceedings.
The lead author is Dr. W. Michael Hooten, an anesthesiologist for the Mayo Clinic in Rochester, Minnesota.
“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,” Dr. Hooten says. “That reduces or even eliminates the risk of these medications transitioning to another problem that was never intended.”
The study included 293 patients who received a new prescription in 2009 for an opioid painkiller such as oxycodone, morphine, hydromorphone, oxymorphone, hydrocodone, fentanyl, meperidine, codeine and methadone. The researchers used the NIH-funded Rochester Epidemiology Project to select the random sample of patients for the study.
Researchers said that discovering who is likeliest to end up using the drugs long-term is critically important due to the widespread problems associated with their misuse.
“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,” Dr. Hooten says, citing data from the Centers for Disease Control and Prevention.
Long-term opioid use may actually make people more sensitive to pain, a condition called opioid-induced hyperalgesia, another recently published study by Dr. Hooten and other Mayo researchers found.
If opioids must be used, as is usually the case with surgery or traumatic injuries, reducing the dose and limiting the duration is important, Dr. Hooten says. “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,” he says. “It is possible that higher dose or greater quantities of the drug with each prescription are important predictors of longer-term use.”
MEN MORE LIKELY TO DIE FROM OPIOID ESCALATION
Meanwhile, another study, this one announced in Toronto, Canada said that men who were prescribed opioids are twice as likely as women to escalate to a higher dose and die.
The research by the Institute for Clinical Evaluative Sciences (ICES) found that one in 45 men amplified their dosage over time to more than 200 milligrams of morphine or its equivalent, compared with one in 70 women taking the drugs.
Patients whose opioid use had snowballed were almost 24 times as likely to die as those who did not ramp up the amount of their daily medication, concluded the study, published Thursday in the journal PLOS ONE.
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