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Monday, November 5, 2012

What Are The Risks Associated Opioid Analgesics?

If you are a regular reader of our blog, then you know that we often write about the dangers involved in becoming addicted to prescription drugs particularly when they are prescribed for an acute or chronic pain. The headlines offer warnings of the dangers of opiate based prescription drugs and we know that many people will try opioids in this form simply because that are readily available, they are a legal form of the drug and many don't recognize the dangers; however, once addicted the individual will often turn to hard illegal drugs because they are cheaper and their source for the prescription form dries up. These headlines can work to make people fearful that if they receive a prescription for pain they will risk the chance of developing an addiction to opioids. Interestingly, experts often debate how many people actually do become addicted to opiate based prescription drugs.

Reviewing the research

This past month a new article was released online in the journal Addiction. Three researchers completed a  review of the literature: Development of dependence following treatment with opioid analgesics for pain relief: a systematic review.   This review was conducted by Silvia Minozzi, Laura Amato, and Marina Davoli from Department of Epidemiology, Lazio Regional Health Service, Cochrane Drugs and Alcohol Group, Rome, Italy.

Review methods

The aim of this review was to assess the incidence or prevalence of opioid dependence syndrome in adults (with and without previous history of substance abuse) following treatment with opioid analgesics for pain relief.
  • Reviewers examined 17 previous studies
  • These studies included date from 88,325 participants
  • Most studies included adult patients with chronic non-malignant pain
  • Two studies included patients who were being treated for cancer
  • One study included patients with a previous history of drug dependence
This systematic review prompted the researchers to conclude: Taken together, the studies found that 4.5 percent of people developed a dependency on the painkillers. This rate seems low, so it is important to remember it is an average and the researchers offer that the rate of developing a dependency ranged from 0 to 31%!

Other experts weigh in on the review's conclusions

As we said the online Addiction article was published on October 18, 2012; therefore, now some addiction experts in the United States have had time to read the article and offer some of their own observations. For example, according to Reuters news:
  • Addiction specialist Dr. Michael Fleming at Northwestern University's Feinberg School of Medicine: "If you're a person that doesn't have a history of addiction and doesn't have any major psychiatric problems, narcotics are relatively safe as long as your doctor doesn't give you too much and uses the right medication."
  • Joseph Boscarino of the Geisinger Clinic in Danville, Pennsylvania, who studies pain and addiction offered: '"I think the jury's still out" on how worrisome prescription opioid addiction is.'

Some cautionary thoughts...

When research is conducted we always hope that it is extensive and thorough. Often new research or a review of previous research offers new facts or a revision of previously accepted facts. So what is the average person to do?  First, understand that opioids are addictive. Second, if you had a history of addiction and you are in recovery, then you need to share this information with your doctor so that he/she can prescribe appropriate pain medication. Third, if someone else in your household suffers from opioid addiction, then carefully monitor your prescription making sure that no one else is using your pain medication.


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