Opioid Drug Refills Following Surgery Linked to Risk of Painkiller Abuse, Misuse

The length of time an individuals uses opioid painkillers, not the dose of the controversial medications, may play a significant role in predicting abuse and misuse later, according to the findings of new research. 

In a study published last week in the medical journal The BMJ, researchers studied data involving more than 1 million people who took opioid painkillers for the first time, concluding that the number of opioid refills is a stronger identifier for abuse and misuse than the dosage.

The study’s findings come as health officials throughout the U.S. are dealing with a widespread opioid abuse epidemic. In recent years, the rate of opioid drug overdoses increased nearly 140%, and the manufacturers of the drugs currently face a growing number of lawsuits filed on behalf of local and state government entities, seeking compensation for costs associated with the addictive medications.

Researchers from Harvard Medical School focused on surgical claims from a linked medical and pharmacy administrative database of more than 37 million commercially insured patients in the U.S. between 2008 and 2016. They analyzed more than 1 million patients who had never taken opioids.  Half of those patients underwent surgery and were prescribed narcotic painkillers, like Vicodin, after the procedures.

Of those patients, one percent, or roughly 6,000 records were marked with a code for abuse.

The data also indicated the total duration of opioid use was the strongest indicator of misuse. Researchers found that with each refill, the rate of abuse went up 44%. With each additional week a person used opioids their risk of abuse went up 20%.

Researchers analyzed the data over different years and different states, to see if the trends held up. In each case, duration of use predicted opioid abuse, not the dose given to the patient.

A recent study indicated half of all patients undergoing surgery do not actually need prescriptions for opioid painkillers at discharge, but are given the drugs anyway.

Research published last year concluded people treated in ERs and given opioids are less likely to abuse them because they are given lower doses for shorter periods of time. These factors appear to weigh heavily on whether a patient becomes addicted to the substances.

As opioid abuse problems continue to worsen, the CDC warns death rates due to the opioid crisis may be worse than estimated and opioid abuse problems remain widely underreported.