More Long-Term Opioid Prescriptions Drive Increasing Use

https://www.uspharmacist.com/article/more-longterm-opioid-prescriptions-drive-increasing-use/

Baltimore, MD—Pharmacists are filling many more prescriptions for opioids now than at the end of the last century, and a disturbing percentage of them are for long-term use.

That’s according to a new study from the Johns Hopkins Bloomberg School of Public Health, which determined that opioid prescription use jumped significantly between 1999 and 2014. Much of the increase was related to prescriptions for 90 days or longer, notes the article, published online by the journal Pharmacoepidemiology and Drug Safety.

Results of the review were based on data from the National Health and Nutritional Examination Survey, which the National Center for Health Statistics has conducted every 2 years since 1999–2000. Prescription opioid use increased from 4.1% of U.S. adults in 1999–2000 to 6.8% in 2013–2014, a 60% increase. At the same time, long-term prescription opioid use, defined as 90 days or more, increased from 1.8% in 1999–2000 to 5.4% in 2013–2014.

Of all opioid users in 2013–2014, 79.4% were long-term users compared with 45.1% in 1999-2000, according to the researchers, who point out that long-term use was associated with poorer physical health, concurrent benzodiazepine use, and history of heroin use.

“What’s especially concerning is the jump in long-term prescription opioid use, since it’s linked to increased risks for all sorts of problems, including addiction and overdoses,” explained study author Ramin Mojtabai, MD, PhD, MPH, a professor in the Department of Mental Health at the Bloomberg School. “The study also found that long-term use was associated with heroin use as well as the concurrent use of benzodiazepines, a class of widely prescribed drugs that affect the central nervous system,” he says.

Combining opioids and benzodiazepines significantly increases the risk of overdose, even if the patient is taking a moderate dosage of opioid medication, Mojtabai points out.

For the report, Mojtabai examined eight consecutive biannual surveys, each of which included over 5,000 adults living throughout the U.S. Interviews were conducted via computer in participants’ homes. Participants, totaling more than 47,000 over the eight surveys, were asked to identify prescription medications they had taken in the past 30 days, and for what length of time. The response rate ranged from 71% to 84%.

Opioid-medication use overall and long-term use was more common among participants on Medicaid and Medicare versus private insurance, noted Mojtabai, who added that no randomized clinical trials support opioids’ extended use, because of the risks.

A survey of 5000 people, when there is a estimated 100 + million chronic pain pts… seems like a rather SMALL SAMPLING… and just how were these pts selected for this survey ?

A reported 60% increase in opiate prescriptions from 1999-2000 to 2013 – 2014… does that number compensate for the fact that our population grows about 3%/yr… so in the same time frame our population was abt 40% greater… so based on per million population.. the growth was really MAYBE – 20% ?

This report time frame mostly encompasses what was declared the “decade of pain” when the Joint Commission that accredits all hospitals to be eligible for Medicare/Medicaid payments  declared pain the “Fifth Vital Sign” and made it a MAJOR STANDARD for hospitals to meet and the failure to meet that standard could mean that the hospital loss their accreditation…

Imagine that there is… “….no randomized clinical trials support opioids’ extended use, because of the risks …”

ALL CLINICAL TRIALS HAVE RISKS !!!

perhaps clinical trials of new/unproven medications have MORE RISKS than a clinical trial of a otherwise known safe medication.  Can you say… LAME EXCUSE ???

Filed under: General Problems