Opioid Misuse Predicted By Duration And Number Of Prescription Refills, Not Dosage
Researchers found in a new study that the duration and number of opioid prescription refills that a patient receives following surgery is a significantly greater risk factor for dependence and overdose than the actual dosage taken.
The study, which included data from over 560,000 individuals who were given opioids after surgery and did not have a prior history of long-term opioid use, revealed that each additional week that a patient took opioid, increased the risk for addiction or a non-fatal overdose (defined as misuse) by 20%.
Also, each refill increased the risk by 44%, and the first refill more than doubled it. Meanwhile, dosage was a much less significant factor for misuse, and researchers stated that for those who used opioids for less than two weeks, the risk of misuse was about the same as that for patients who took dosages at twice the amount.
In total, around 5,900 study subjects developed opioid dependence or experienced a non-fatal overdose. One-third of those diagnoses were given during the year following the patient’s surgery.
Since the turn of the century, overdoses involving opioid in the U.S. have tripled, and are now the #1 cause of accidental death. The authors noted that most deaths could be linked to an opioid that was originally prescribed, and past research has found that 3-10% of first-time opioid patients move on to chronic use.
The study’s senior author, Nathan Palmer, a biomedical informatics researcher, via a Harvard news release.
“We are in the midst of an epidemic, and physician prescription practices play no small part in it.”
“Understanding differences in risk for opioid misuse across various patient populations and clinical contexts is critical in informing the creation of narrowly tailored guidelines, clinical decision making and the national conversation on this topic.”
Researchers stressed that these results reveal how critical it is to monitor the length of time people use opioids after surgery and the number of refills.
The study was conducted by Harvard Medical School researchers and was published this month in the BMJ.
~ G. Nathalee Serrels, M.A., Psychology