19 Mar Long-Term Opioid Use Increases With Each Additional Day On Opioid Therapy
MedicalResearch.com Interview with:
Anuj Shah (B.Pharm)
Division of Pharmaceutical Evaluation and Policy
University of Arkansas for Medical Sciences
MedicalResearch.com: What is the background for this study?
Response: The CDC guideline on opioid prescribing, published in March 2016, included recommendations for initiation of opioid therapy. The guideline noted that there is a lack of data describing how acute opioid use transitions to long-term opioid use. This report seeks to address this gap by determining characteristics of initial opioid prescribing prognostic of long-term use, among opioid naïve cancer-free adults.
MedicalResearch.com: What are the main findings?
Response: The probability of long-term opioid use increases with each additional day on opioid therapy. The likelihood of long-term use doubles if a person is prescribed more than 5 days’ worth of opioids in their first prescription. Persons starting on a long-acting opioid or Tramadol were also more likely to remain on opioids than persons prescribed hydrocodone or oxycodone.
MedicalResearch.com: What should readers take away from your report?
Response: Transitions from acute to long-term therapy can begin to occur quickly; the chances of chronic use begin to increase after the third day supplied and rise rapidly thereafter. Therefore discussions between patients and physicians about the use of opioids to manage pain should occur as early as within the first week of opioid therapy.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: In the current report we did not account for the reason of receiving the opioid prescription which would be a predictor of long-term use as well. In a follow up study we will determine whether the characteristics of initial prescribing impact likelihood of long-term use even after accounting for the reason of the opioid prescription.
More recently states have passed laws limiting the days’ supply of opioid prescriptions.
Future research should determine whether such laws can substantially reduce the rate of opioid related adverse outcomes.
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Shah A, Hayes CJ, Martin BC. Characteristics of Initial Prescription Episodes and Likelihood of Long-Term Opioid Use — United States, 2006–2015. MMWR Morb Mortal Wkly Rep 2017;66:265–269. DOI: http://dx.doi.org/10.15585/mmwr.mm6610a1
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