Many chronic pain patients suffer from opioid misuse

A comprehensive review of 148 studies involving over 4.3 million adult chronic pain patients has revealed alarming rates of opioid misuse.

Conducted by researchers at the University of Bristol and published in the journal Addiction, the review found that nearly one in ten patients develops opioid dependence or opioid use disorder, while nearly one in three shows signs of these conditions.

These findings highlight a much higher rate of opioid misuse than previously reported.

Pharmaceutical companies like Purdue Pharma, the maker of Oxycontin, have long claimed that fewer than 1% of opioid prescriptions lead to problems.

This new review significantly challenges those assertions, demonstrating that the risks associated with opioid use are far greater.

The review categorized the 148 studies into four groups based on how they defined problematic opioid use:

1. Dependence and Opioid Use Disorder: 43 studies used diagnostic codes to identify opioid misuse formally.
2. Signs and Symptoms of Dependence and Opioid Use Disorder: 44 studies identified behaviors like craving, tolerance, or withdrawal without specific diagnostic codes.
3. Aberrant Behavior: 76 studies looked for concerning behaviors such as seeking early refills or frequently losing prescriptions.
4. At Risk of Dependence and Opioid Use Disorder: 8 studies focused on characteristics that might increase the risk of developing opioid misuse in the future.

Some studies reported multiple types of problematic use, so the total number exceeds 148. The prevalence rates for each category were:

• Dependence and Opioid Use Disorder: 9.3% (nearly 1 in 10 patients).
• Signs and Symptoms of Dependence and Opioid Use Disorder: 29.6% (nearly 1 in 3 patients).
• Aberrant Behavior: 22% (more than 1 in 5 patients).
• At Risk of Dependence and Opioid Use Disorder: 12.4% (nearly 1 in 8 patients).

Professor Kyla Thomas, the lead author, emphasized the need for clinicians and policymakers to have accurate estimates of opioid misuse. This knowledge is crucial for understanding the true extent of the problem, potentially revising prescribing guidelines, and developing effective interventions to manage opioid misuse.

The studies reviewed were mostly from North America and other high-income countries, with 106 of the 148 studies conducted between 2010 and 2021.

The oldest study dated back to 1985, and study sizes ranged from 15 to over 2.3 million patients. Due to the varied nature of these studies, the findings should be approached with some caution.

This review underscores the pressing need for a better understanding of opioid misuse in chronic pain patients. As patients continue to rely on opioids for pain management, the healthcare system must adapt to address and mitigate the risks of opioid dependence and misuse effectively.

If you care about pain, please read studies about how to manage your back pain, and Krill oil could improve muscle health in older people.

For more information about pain, please see recent studies about how to live pain-free with arthritis, and results showing common native American plant may help reduce diarrhea and pain.

The research findings can be found in Addiction.

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