A new scientific review has revealed alarming rates of misuse and addiction among chronic pain patients who are treated with prescription opioid painkillers.
The review, conducted by researchers at the University of Bristol, examined 148 studies involving over 4.3 million adults with chronic pain.
The findings show that nearly 1 in 10 patients develops opioid dependence or opioid use disorder, while almost 1 in 3 exhibits symptoms of dependence or addiction.
This review provides a more accurate and concerning picture of opioid misuse than previously thought.
In the past, companies like Purdue Pharma, the maker of Oxycontin, claimed that fewer than 1% of patients prescribed opioids would experience problems. However, this new research suggests that the actual risks are much higher.
The researchers categorized the 148 studies into four groups based on how they defined problematic opioid use:
- Dependence and Opioid Use Disorder: This category included 43 studies that used formal diagnostic codes to identify opioid dependence or addiction. The review found that 9.3% of patients, or nearly 1 in 10, fell into this category.
- Signs and Symptoms of Dependence and Opioid Use Disorder: In this group of 44 studies, researchers looked for behaviors such as craving, tolerance, or withdrawal symptoms, without using specific diagnostic codes. Nearly 1 in 3 patients (29.6%) showed signs of dependence or addiction.
- Aberrant Behavior: This category included 76 studies that identified concerning behaviors, such as seeking early refills, increasing doses frequently, or frequently losing prescriptions. More than 1 in 5 patients (22%) exhibited such behaviors.
- At Risk of Dependence and Opioid Use Disorder: This smaller category of 8 studies looked at characteristics that might increase the risk of developing opioid dependence or addiction in the future, affecting nearly 1 in 8 patients (12.4%).
Some studies reported multiple results for the same patients, which is why the total number of studies in the categories exceeds 148.
Professor Kyla Thomas, the lead author of the study, emphasized the importance of these findings. “Clinicians and policymakers need accurate estimates of the prevalence of opioid misuse among pain patients.
This helps them understand the true extent of the problem, adjust prescribing guidelines if necessary, and create effective strategies to manage and prevent opioid addiction.”
The studies in this review were mostly conducted in North America and other high-income countries, with 106 of them carried out between 2010 and 2021. The study sizes varied widely, from as few as 15 to as many as 2.3 million patients.
While the findings highlight the significant risks of opioid use, they should be interpreted carefully due to the diverse nature of the studies reviewed.
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