April 15, 2015
Study Reports Rate of Opioid Misuse, Questions
Widespread Prescribing

Albuquerque, NM—How often are prescription pain drugs actually misused? About 20% to 30% of the time, according to a new study, which also estimates the rate of opioid addiction at about 10%.

In light of the harmful consequences, authors of the study, published recently in the journal Pain, raise questions about the benefits of widespread opioid use for chronic pain.

“On average, misuse was documented in approximately one out of four or five patients and addiction in approximately one out of ten or eleven patients,” write the authors, led by researchers from the University of New Mexico Albuquerque. The reported rates of misuse, abuse, and addiction, vary widely, however, they add.

For the report, researchers used data from 38 reports to calculate estimates, with adjustments for study sample size, quality, and methods. With three specific types of problem opioid use recorded, misuse, abuse, and addiction, the study found significant variability in specific rates of opioid misuse and addiction identified across different studies—ranging from less than 0.1% to more than 80%.

After adjusted analysis, the average percentage of opioid misuse was estimated at 21% to 29%. Misuse was defined as using opioids contrary to instructions, regardless of harmful or adverse effects.

At the same time, adjusted average rates of opioid addiction—defined as continued opioid use with actual or potential harmful effects—ranged from 8% to 12%. The rate of opioid abuse—intentionally using the drugs for nonmedical purposes—was only included in one study, the authors note.

“The results of this review have two key implications,” according to the researchers. “First, misuse and addiction do seem to be distinct patterns of problematic opioid use, at least based on the definitions used here and the differences in observed mean rates between them. Second, misuse seems more common than addiction. Several types of misuse were identified within studies and included underuse, erratic or disorganized use, inappropriate use (e.g., to manage symptoms of anxiety or other sorts of distress), use in conjunction with alcohol or illegal substances (e.g., marijuana), and, of course, overuse. If it is accurate that approximately 1 in 4 patients on opioids display patterns of opioid misuse, but not addiction, then perhaps more efficient targeting of treatment resources would be of benefit.”

In general, they also raise concerns about the widespread use of opioids for chronic pain treatment, writing, “We are not certain that the benefits derived from opioids, which are rather unclear…compensate for this additional burden to patients and health-care systems.”

U.S. Pharmacist Social Connect