A review of 148 studies involving over 4.3 million adult chronic pain patients treated with prescription opioids found that nearly 1 in 10 experiences opioid dependence or disorder, and almost 1 in 3 shows symptoms of misuse.
This study, led by the University of Bristol, reveals a much higher rate of opioid misuse than previously reported, challenging claims by companies like Purdue Pharma that the risk is minimal.
The researchers grouped the 148 studies into four categories based on how they defined problematic opioid use:
- Dependence and opioid use disorder: 43 studies used formal diagnostic codes.
- Signs and symptoms: 44 studies examined behaviors like craving or withdrawal without specific diagnoses.
- Aberrant behavior: 76 studies focused on inappropriate actions like early refills.
- At risk: 8 studies identified factors that could increase future risk of dependence.
Some studies reported multiple results using different methods, so the total exceeds 148. The rates of problematic opioid use were:
- Dependence and opioid use disorder: 3%, or nearly 1 in 10 patients.
- Signs and symptoms: 6%, or almost 1 in 3 patients.
- Aberrant behavior: 22%, or more than 1 in 5 patients.
- At risk: 4%, or nearly 1 in 8 patients.
Kyla Thomas, a Public Health Medicine Professor at the University of Bristol and lead author of the study, emphasized that accurate estimates of opioid misuse are crucial for clinicians and policymakers to address the problem effectively.
The majority of studies reviewed were from North America and high-income countries, with 106 conducted between 2010 and 2021. The study sizes varied greatly, so findings should be interpreted carefully.
The study concludes that misuse and addiction to prescription painkillers are common among chronic pain patients. This widespread issue highlights the need for better management and stricter guidelines to prevent and address opioid misuse.
Journal reference :
- Kyla H. Thomas, Michael N. Dalili et al., Prevalence of problematic pharmaceutical opioid use in patients with chronic non-cancer pain: A systematic review and meta-analysis. Addiction. DOI: 10.1111/add.16616.
