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Patients who receive opioids at lower doses are less likely to progress to long term use

28 September, 2017
ERs Prescribing Opioids at Lower Doses, Shorter Durations. By Mary Elizabeth Dallas. medlineplus.gov.* September 26, 2017. Patients who receive these prescriptions are less likely to progress to long-term use, study shows. Emergency room doctors write lower-dose, shorter-term prescriptions for opioids than other doctors do, new research shows. The study, led by scientists at the Mayo Clinic, challenges views that emergency departments are the main source of prescriptions for the powerful painkillers whose use — and misuse — has soared in recent years.The research also suggests that patients who get an opioid prescription — such as for oxycodone (OxyContin) — during an ER visit are less likely to abuse the drugs over the long term.* Health news articles are no longer available on MedlinePlus.
Patients who receive opioids at lower doses are less likely to progress to long term use
Sobredosis de metadona y otros opioides
HealthDay news image"There are a few things that many people assume about opioids, and one is that, in the emergency department, they give them out like candy," said the study’s lead author, Molly Jeffery. She is scientific director of the Mayo Clinic division of emergency medicine research, in Rochester, Minn.
"This idea didn’t really fit with the clinical experience of the emergency department physicians at Mayo Clinic, but there wasn’t much information out there to know what’s going on nationally," she added in a hospital news release.
For the study, the researchers analyzed 5.2 million opioid prescriptions — written for sudden or new pain — in the United States between 2009 and 2015. None of the patients included in the study had received an opioid prescription within the past six months, allowing the researchers to compare doses and eliminate patients who developed a tolerance for the painkillers.
Patients with private insurance who got the prescription in the ER were 44 percent less likely to take more than their three-day supply than those who got their prescription from another source. They were also 38 percent less likely to take more than 50-milligram (mg) of morphine or its equivalent (nearly seven pills of 5-mg oxycodone). And they were 46 percent less likely to advance to long-term opioid use.
The results were similar for patients with Medicare, the findings showed.
The 50-mg daily recommendation comes from the U.S. Centers for Disease Control and Prevention. But outside the ER, the report found, one in five patients with private insurance received a higher dose.
The researchers noted that those who received a higher dose were three times more likely to progress to long-term use. This was true regardless of where they got their prescription.
According to study senior author Dr. M. Fernanda Bellolio, "Patients and physicians should be aware of the risk of long-term use when they’re deciding on the best treatment for acute pain." Bellolio is research chair of Mayo’s department of emergency medicine.
The study authors said they hope their findings help curb the opioid epidemic by determining the best dosage to suit patients’ needs.
Over the past 15 years, the number of Americans receiving an opioid prescription and the number of related overdoses have roughly quadrupled, according to the CDC. In 2015 alone, more than 41 people suffered a fatal opioid overdose each day.
The study was published Sept. 26 in Annals of Emergency Medicine.
SOURCE: Mayo Clinic, news release, Sept. 26, 2017
Read related: CDC Launches Opioid Campaign in Hard-Hit States. By Robert Preidt. medlineplus.gov.*  September 26, 2017. ‘It only takes a little to lose a lot’ is slogan for the multi-pronged media effort. The U. S. Centers for Disease Control and Prevention has launched a campaign to reduce overdose deaths from prescription opioid painkillers.
Between 1999 and 2015, more than 183,000 people in the United States died from prescription opioid overdoses such as OxyContin (oxycodone) and Vicodin (hydrocodone).
The goal of the CDC’s Rx Awareness campaign is to increase knowledge of the risks of prescription opioids and stop inappropriate use. Personal accounts from recovering opioid abusers and people who’ve lost loved ones will be featured.
"It only takes a little to lose a lot" is the campaign tagline. It will be featured in videos, audio ads, social media ads, internet banners, web graphics, billboards and posters.
Campaign ads are planned to run for the next 14 weeks in Kentucky, Massachusetts, New Mexico and Ohio. The campaign will expand to other states as more funding becomes available.
"This campaign is part of CDC’s continued support for states on the frontlines of the opioid overdose epidemic," CDC Director Dr. Brenda Fitzgerald said in an agency news release.
"These heartbreaking stories of the devastation brought on by opioid abuse have the potential to open eyes and save lives," she said.
In 2015, 12.5 million people in the United States misused prescription opioids. Every day, more than 1,000 people are treated in emergency departments for prescription opioid misuse and more than 40 people die from prescription opioid overdoses.
Prescription opioid abuse is also a major risk factor for heroin use. About three-quarters of new heroin users misused prescription opioids before using heroin.
SOURCE: U.S. Centers for Disease Control and Prevention, news release, Sept. 25, 2017
HealthDay* Health news articles are no longer available on MedlinePlus.


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