Opioid benefits may not outweigh risks

April 20, 2015

After an extensive review, researchers said they were unsure whether the risks of prescription opioids outweighed the potential benefits for managing chronic pain.

After an extensive review, researchers said they were unsure whether the risks of prescription opioids outweighed the potential benefits for managing chronic pain.

“The efficacy of opioids and their suitability for the long-term management of chronic pain still remain very much in question….it stands in somewhat stark contrast to the clinical reality of chronic pain treatment, where rates of prescriptions have skyrocketed such that opioids are now among the most frequently prescribed medications,” wrote Kevin E. Vowles with the Department of Psychology at the University of New Mexico in Albuquerque, in the review published in the April, 2015, issue of Pain.

Vowles and his fellow researchers at the University of Washington in Seattle, Wash., and the UNM, found that the average rates of opioids misuse ranged between 21% and 29%. The rates of addiction averaged between 8% and 12%, while abuse was reported in only a single study.

Related: FDA: Final guidance on evaluation, labeling of abuse-deterrent opioids

After reviewing 38 published studies, most of which were conducted in the United States, the researchers discovered 2 primary implications. Misuse and addiction seem to be distinct patterns of problematic opioid use, and misuse seems more common than addiction. As a result, some misuses of prescription opioids may be addressed by “low-intensity intervention,” such as monthly counseling sessions, the researchers wrote.

Related: New HHS plan on opioids ups naloxone use

“If it is accurate that approximately one in four patients on opioids display patterns of opioid misuse, but not addiction, then perhaps more efficient targeting of treatment resources would be of benefit,” Vowles wrote. “Some forms of misuse, for example, may be readily addressed through relatively low-intensity methods such as education or frequent follow-up visits.”

One study in which monthly counseling sessions were provided showed that “there are alternatives available to providers who treat high-risk patients beyond simply not prescribing the medications at all,” Jowles wrote.

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