Why do some people still need to use a prescription for painkillers?
A prescription for morphine and codeine is often the first step for treating severe pain, but it is not the only option for people who cannot tolerate painkillers, according to a new study from the University of Rochester Medical Center.
The study, published online today in the journal Pain, explored the role of opioids, a class of painkillers that include morphine, oxycodone and codeinone, in the treatment of chronic pain.
“A prescription for opioid analgesics may not be the first choice for pain patients, but if they can’t afford an opioid medication, it could be the only one available to them,” said senior author Dr. Matthew T. Hausman, an assistant professor of medicine in the department of medicine at the University at Buffalo.
“These drugs are often used as an alternative to opioids, which have a higher potential for addiction and overdose.”
People who cannot afford an opiate medication can often find relief with a combination of pain relievers, but people who do not have access to opioids should consider alternative treatments.
“Hausman said the study examined the relationship between pain and the prevalence of opioid use among individuals with chronic pain and their families.
It found that opioid use was significantly associated with pain severity, a key indicator of severity of pain, as well as with a higher prevalence of depression, anxiety and substance abuse.”
These results show that a substantial proportion of people do not receive a full, safe and effective treatment for their chronic pain.””
The use of opioids has become a significant public health problem.
These results show that a substantial proportion of people do not receive a full, safe and effective treatment for their chronic pain.”
The study used data from the National Longitudinal Survey of Adolescent Health (Add Health) and the National Comorbidity Survey Replication (NCS-R), two of the largest ongoing surveys of US adults conducted by the Centers for Disease Control and Prevention (CDC).
The survey collected information on the demographics of adults aged 15 and older who self-identified as having chronic pain, chronic anxiety disorder, and depression and who had received at least one prescription for opioids.
The survey also asked about other factors that may influence use of pain medications, including social, economic, and religious factors.
Hausmann and his colleagues examined data from a subset of this subset, those who used opioids in the past year.
They found that among adults aged 18 to 59 who self reported using opioids in their lifetime, the odds of using opioids for pain increased from 5.3 to 9.1 percent, a significant increase from the previous report, which found a prevalence of 6.1.
A more recent analysis of the data by the authors also showed a significant association between pain severity and opioid use, with a prevalence greater than 7 percent among people who used morphine or codeine more than once per day.
Haumans findings were echoed by other research.
“Prescription opioids are associated with increased rates of depression and anxiety and a higher rate of substance use,” said Dr. Michael W. Durbin, an associate professor of health sciences at the Icahn School of Medicine at Mount Sinai, who was not involved in the study.
“These data suggest that the current opioid crisis has the potential to exacerbate chronic pain for many patients.”
Durbin is a co-author of the report, and he noted that more research is needed to understand the specific mechanisms that contribute to the increased risk for opioid use.
Henslow said his organization has recently begun to investigate the use of opioid analgesic prescriptions among chronic pain patients.
“We want to know how opioids influence the patient’s health and pain management, and whether opioids are used by patients with chronic medical conditions to manage chronic pain in their treatment,” he said.
“It’s also important to understand how opioids are marketed, whether they are prescribed in an effort to reduce the risk for overdose, and the long-term risks of misuse.”###