Opioid dependence can start in just a few days

March 16, 2017 by Steven Reinberg, Healthday Reporter

(HealthDay)—Doctors who limit the supply of opioids they prescribe to three days or less may help patients avoid the dangers of dependence and addiction, a new study suggests.

Among without cancer, a single day's supply of a narcotic painkiller can result in 6 percent of patients being on an opioid a year later, the researchers said.

The odds of long-term opioid use increased most sharply in the first days of therapy, particularly after five days of taking the drugs. The rate of long-term opioid use increased to about 13 percent for patients who first took the drugs for eight days or more, according to the report.

"Awareness among prescribers, pharmacists and persons managing pharmacy benefits that authorization of a second opioid prescription doubles the risk for opioid use one year later might deter overprescribing of opioids," said senior researcher Martin Bradley. He is from the division of pharmaceutical evaluation and policy at the University of Arkansas for Medical Sciences.

"The chances of long-term opioid use, use that lasts one year or more, start increasing with each additional day supplied, starting after the third day, and increase substantially after someone is prescribed five or more days, and especially after someone is prescribed one month of ," Bradley said.

The odds of chronic opioid use also increase when a second prescription is given or refilled, he noted.

People starting on a long-acting opioid or tramadol (Ultram) were more likely to stay on opioids than those given hydrocodone (Vicodin) or oxycodone (Oxycontin), Bradley said.

The highest probability of continued opioid use at one and three years was seen among patients who started on a long-acting opioid, followed by patients who started on tramadol, he said.

Tramadol is a narcotic-like painkiller that has been touted as not being addictive. Patients can, however, become dependent on tramadol.

Patients need to discuss the use of narcotic painkillers when they are prescribed, Bradley said.

"Discussions with patients about the long-term use of opioids to manage pain should occur early in the opioid-prescribing process," he said.

One addiction expert agreed.

"Prescribers should be cautious about what they prescribe, and they should educate patients that if they are going to prescribe opioids, there is a likelihood that patients will have an ," said Dr. Scott Krakower. He is assistant unit chief of psychiatry at Zucker Hillside Hospital, in Glen Oaks, N.Y.

Given the dangers of opioids, doctors should first think about using non-narcotic pain medications, he suggested.

Krakower thinks that since the crackdown on opioids, doctors are becoming more cautious when prescribing them. But doctors also need to be cautious about prescribing tramadol, he said.

"No one planned to get hooked on , but it has some dependent properties," Krakower noted.

He believes that patients who need a narcotic should be given one. "The problem is that so many patients were prescribed opioids, and the odds of becoming dependent are very high," Krakower said.

Once someone becomes addicted to opioids, it can take years to kick that dependence, he said.

"If your doctor is going to prescribe an opioid, be educated about what it can potentially do," Krakower said.

For the study, researchers looked at a sample of patients drawn from data from health insurers and managed care plans. Specifically, they looked at opioid use among patients not being treated for cancer.

The report was published March 17 in the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

Drug overdose deaths have quadrupled since 1999. More than six out of 10 involve , according to the CDC. Ninety-one people die every day in America from or heroin, the agency says.

Prescriptions for have nearly quadrupled since 1999 even though there's been no overall change in Americans' reported pain levels, according to the CDC.

Explore further: Combining opioids with anti-anxiety medicines linked to greater risk of overdose

More information: Martin Bradley, PharmD, Ph.D., division of pharmaceutical evaluation and policy, College of Pharmacy, University of Arkansas for Medical Sciences, Little Rock; Scott Krakower, D.O., assistant unit chief, psychiatry, Zucker Hillside Hospital, Glen Oaks, N.Y.; March 17, 2017, Morbidity and Mortality Weekly Report

Visit the U.S. National Institute on Drug Abuse for more on opioids.

Related Stories

Combining opioids with anti-anxiety medicines linked to greater risk of overdose

March 14, 2017
Taking opioids (strong prescription painkillers) together with benzodiazepines (widely used to treat anxiety and sleep problems) is associated with greater risk of opioid overdose, finds a study in The BMJ today.

Physicians' opioid prescribing patterns linked to patients' risk for long-term drug use

February 16, 2017
Emergency room patients treated by physicians who prescribe opioids more often are at greater risk for long-term opioid use even after a single prescription than those who see less-frequent prescribers, according to the findings ...

Amnesia affecting some opioid abusers

January 26, 2017
(HealthDay)—Short-term memory loss may be yet another price of America's opioid addiction epidemic.

UVA slashes opioid use while improving pain scores, study finds

January 18, 2017
A study of more than 100,000 surgical cases at University of Virginia Health System found patients' pain scores improved even as doctors gave fewer opioids.

Despite opioid concerns, seniors often exit the hospital with prescription, study says

July 19, 2016
It's a common scenario: Someone checks into a hospital for surgery or an illness and leaves with a prescription for an opioid painkiller, opening the door to long-term use and dependence. A recent study examined this pattern ...

Many patients continue using opioids months after joint replacement

May 31, 2016
Many patients undergoing hip or knee replacement are still taking prescription opioid pain medications up to six months after surgery, reports a study in Pain, the official publication of the International Association for ...

Recommended for you

New study finds concurrent use of prescription drugs and dietary supplements could pose health risks

September 25, 2018
A new University of Hertfordshire study found that using certain over-the-counter herbal medicines and dietary supplements alongside prescription drugs could pose serious health risks, especially amongst older adults.

Drug overdose epidemic has been growing exponentially for decades

September 20, 2018
Death rates from drug overdoses in the U.S. have been on an exponential growth curve that began at least 15 years before the mid-1990s surge in opioid prescribing, suggesting that overdose death rates may continue along this ...

Anti-cancer drugs may hold key to overcoming antimalarial drug resistance

September 20, 2018
Scientists have found a way to boost the efficacy of the world's most powerful antimalarial drug with the help of chemotherapy medicines, according to new research published in the journal Nature Communications.

Probiotic use may reduce antibiotic prescriptions, researchers say

September 14, 2018
Use of probiotics is linked to reduced need for antibiotic treatment in infants and children, according to a review of studies that probed the benefits of probiotics, say researchers in the U.S., England and the Netherlands.

Recalled blood pressure drugs not linked to increased short term cancer risk

September 12, 2018
Products containing the withdrawn blood pressure drug valsartan are not associated with a markedly increased short term risk of cancer, finds an expedited analysis published by The BMJ today.

Sugar pills relieve pain for chronic pain patients

September 12, 2018
Someday doctors may prescribe sugar pills for certain chronic pain patients based on their brain anatomy and psychology. And the pills will reduce their pain as effectively as any powerful drug on the market, according to ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.