Tag Archives: abuse-rate

Effectiveness and Risks of Long-Term Opioid Tx

The Effectiveness and Risks of Long-Term Opioid Treatment of Chronic Pain. – PubMed – NCBI – Sep 2014

I originally found this in a government-sponsored Research Review, from the Effective Health Care Program (Helping You Make Better Treatment Choices) under the Agency for Healthcare Research and Quality (AHRQ).

But now in 2019, I can’t find it there anymore. I can only find the abstract of what used to be a 219-page report, which had reached the same non-conclusion as all other studies of the last couple of decades: “more research is needed”, used when the study doesn’t find the results they wanted.

I think this increasingly common “conclusion” to studies of opioids is a pathetic evasion of the full truth.  Continue reading

National Institute of Drug Abuse on the Opioid Crisis

First, commentary by @StefanKertesz:

This is probably the best summary of the crisis I’ve seen. It’s got lots of references supporting all of its claims, and lots of links to more detailed information.

Note that pharma and misprescribing played a role, but that diversion and misuse are also specifically mentioned as key factors.

And this is NIDA, a government agency that presumably not unduly influenced by Big Pharma on one side or PROP on the other.   Continue reading

Low Risk of Opioid Use Disorder in Primary Care

Low Risk of Producing an Opioid Use Disorder in Primary Care by Prescribing Opioids to Prescreened Patients with Chronic Noncancer Pain | Pain Medicine | Oxford Academic – March 2017

This study shows what pain patients have been saying all along: prescribing opioids for patients with chronic pain very rarely causes problems of drug abuse.

Objective: 

To examine the risk of developing aberrant behaviors that might lead to a substance use disorder (addiction) when prescribing opioids for the relief of chronic noncancer pain in primary care settings.   Continue reading

Overdose and Other Drug and Addiction Myths

Overdose and Other Drug and Addiction Myths  – Psychology Today – by Stanton Peele Ph.D. – Jan 2018

  1.  Drug Overdose

Tom Petty died from, according to the New York Times headline (link is external), an “Accidental Drug Overdose.”

Here’s the coroner’s list of the drugs found in Petty’s system:

  1. fentanyl,
  2. oxycodone,
  3. temazepam,
  4. alprazolam,
  5. citalopram,
  6. acetyl fentanyl and
  7. despropionyl fentanyl. 

Continue reading

Low Risk of OUD in Primary Care Opioid Prescribing

Low Risk of Producing an Opioid Use Disorder in Primary Care by Prescribing Opioids to Prescreened Patients with Chronic Noncancer Pain | Pain Medicine | Oxford Academic – Pain Medicine, Volume 19, Issue 4, 1 April 2018

This longitudinal and prospective study seems to be of high quality and shows what we’ve known all along: among pain patients, in general, there is only a small chance of developing problems with opioid abuse.

Objective: To examine the risk of developing aberrant behaviors that might lead to a substance use disorder (addiction) when prescribing opioids for the relief of chronic noncancer pain in primary care settings.

Design: Longitudinal, prospective, descriptive design with repeated measures.   Continue reading

Less than 5% Risk of Opioid Use Disorder in Patients

Low Risk of Producing an Opioid Use Disorder in Primary Care by Prescribing Opioids to Prescreened Patients with Chronic Noncancer Pain. – PubMed – NCBI –  2017 Mar

Here’s the main finding of this study:

Less than 5% of our study population
revealed any evidence of substance use disorder.

Objective. :

To examine the risk of developing aberrant behaviors that might lead to a substance use disorder (addiction) when prescribing opioids for the relief of chronic noncancer pain in primary care settings.  Continue reading

Effectiveness and Risks of Long-Term Opioids for Chronic Pain

The Effectiveness and Risks of Long-Term Opioid Treatment of Chronic Pain | Agency for Healthcare Research & Quality from U.S. Department of Health & Human Services |Oct. 22, 2014

This report reviews the current evidence on effectiveness and harms of opioid therapy for chronic pain.

Objectives: Chronic pain is common and use of long-term opioid therapy for chronic pain has increased dramatically. This report reviews the current evidence on effectiveness and harms of opioid therapy for chronic pain, focusing on long-term (>1 year) outcomes.

Since there are NO controlled studies of opioid use lasting over a year, this objective should be impossible.  Continue reading

Opioid misuse, abuse, and addiction in chronic pain

Here are two articles covering the latest alarmist opiophobic headlines:

Study Claims 10% of Pain Patients Addicted to Opioids — Pain News Network

In a systematic review of 38 research reports (a study of studies) published in the journal PAIN, lead author Kevin Vowles and his colleagues estimate that up to 30 percent of the opioids prescribed for pain are misused and that about 10 percent of pain patients are addicted to them.They also question whether opioids should be prescribed at all for chronic pain.

The researchers noted there was extremely wide variation in the rates of opioid misuse and addiction in the studies they analyzed. Rates of “problematic use” ranged from less than 1% all the way up to 81%.

Vowles defined misuse as “opioid use contrary to the directed or prescribed pattern of use, regardless of the presence or absence of harm or adverse effects.” Such a definition means a patient who has stopped using a prescribed opioid – even if they no longer have pain – is misusing the medication. 

With this criteria, the study is clearly biased, but that won’t stop the opiophobes from using to support their anti-opioid positions. Continue reading

Rate of Addiction in Chronic Pain Patients < 3.27%

Screening for Addiction and Monitoring for Aberrant Behavior in Patients with Chronic Pain | All Things Chronic

A fellow blogger, Painkills2, found and commented on this information:

https://gamamed.org/opioidtraining/Speaker4-presentation.pdf

Prevalence of Addiction in Chronic Pain Patients

  • 24 studies with 2,057 patients with rate of 3.27% for abuse/addiction.
  • Rate of abuse/addiction in patients with no history or current use of substances was 0.19%
  • Fishbain DA. Pain Med. 2008;9:444-58

Continue reading

The Effectiveness and Risks of Long-Term Opioid Tx of Chronic Pain

The Effectiveness and Risks of Long-Term Opioid Treatment of Chronic Pain

This is a government sponsored Research Review, from the Effective Health Care Program (Helping You Make Better Treatment Choices) under the Agency for Healthcare Research and Quality (AHRQ).  Below is the abstract from the 219-page report, which reaches the non-conclusion that has resulted from all other long-term studies: “More research is needed“.

Objectives.

Chronic pain is common and use of long-term opioid therapy for chronic pain has increased dramatically. This report reviews the current evidence on effectiveness and harms of opioid therapy for chronic pain, focusing on long-term (>1 year) outcomes.

Continue reading