Prescriptions for opioid pain relievers have nearly doubled over the past 10 years, while prescriptions for nonopioid painkillers have more or less flatlined, leading researchers to question whether the increased use of opioids has improved identification and treatment of pain.
In a study published in the October issue of the journal Medical Care, researchers found Opioid prescriptions for pain relief rose from 11.3% in 2000 to nearly 20% in 2010, an increase of nearly double the amount of opioid pain reliever prescriptions. However, the researchers indicate that the increase has not resulted in better pain management treatment.
“We found that not only have the rates of treated pain not improved, but in many cases, use of safer alternatives to opioids, such as medicines like ibuprofen and acetaminophen, have either stayed flat or declined,” lead researcher Dr. G. Caleb Alexander said in a press release. “This suggests that efforts to improve the identification and treatment of pain have backfired, due to an over-reliance on prescription opioids that have caused incredible morbidity and mortality among patients young and old alike.”
Dr. Alexander and his team of researchers from the Johns Hopkins Center for Drug Safety and Effectiveness studied information from the Analysis of National Ambulatory Medical Care Survey (NAMCS) on nearly 164 million office visits in 2010. They focused on patients who reported experiencing non-cancer pain and which medications were prescribed for those ailments.
While the team found an increase of opioid prescribing, they also found prescribing for nonopioid pain relievers was mostly unchanged. Rates stayed steady from 26% in 2000 and only rose three percentage points to 29% in 2010.
The study also found that half of new doctor office visits for pain resulted in pain killer treatment. Severe non-cancer pain was diagnosed at one-fifth of the clinical visits, however the proportion of doctor visits which were scheduled for pain problems saw no significant changes.
However, among new pain diagnoses prescriptions of nonopioid drugs decreased from 38 percent of visits to 29% of visits by 2010.
The proportion of doctor visits which were treated with either type of pain relief was also unchanged. The percentage of patients receiving both opioid and nonopioid medications increased during the 10 year period.
Opioid Painkiller Abuse
With prescriptions for opioid drugs increasing and nonopioid drugs flat or decreasing, researchers say nonopioid painkillers are severely underutilized and under-prescribed for pain relief.
This study comes at a time of increasing concern over opioid painkiller abuse and a push for new limits on opioid medications. The rate of painkiller abuse and overdose deaths in recent years has led the U.S. Centers for Disease Control and Prevention (CDC) to declare prescription drug overdose deaths at “epidemic” levels.
Opioid painkillers such as Vicodin, Oxycontin and others have gained attention as rates of prescription drug abuse have risen. A recent poll of Americans revealed one in 10 Americans use another person’s prescription drugs, often to get high.
Earlier this month the FDA announced new painkiller requirements for extended-release and long-acting opioid drugs. The new requirements include new label warnings and requires manufacturers to conduct post-marketing studies on overdose and abuse risks.