A recent study published in the journal Pharmacoepidemiology & Drug Safety (PDS) examined trends in prescription opioid use in the United States from 1999 through 2000, and from 2013 through 2014, and results were compared. Specifically, this study looked at long-term opioid use, which was defined as the use of prescription opioids for 90 days or longer.
In 1999-2000, 4.1 percent of adults were taking prescription opioid medications, and from 2013 through 2014, 6.8 percent of US adults were taking prescription opioids. The increase was mostly driven by an increase in the long-term use of prescription opioids, which increased from 1.8 percent of adults to 5.4 percent. Long-term use of opioids correlates with many negative health consequences.
Implications of Long-Term Opioid Use
Long-term use of opioids is associated with worse physical health, a higher incidence of benzodiazepine use, and higher rates of heroin addiction. Therefore, the study concludes, it is essential that doctors carefully weigh the risks and benefits of long-term opioid use in their patients before prescribing it. The medications considered in the study included hydrocodone, tapentadol, oxycodone, oxymorphone, propoxyphene, pentazocine, codeine, meperidine, tramadol, hydromorphone, opium, fentanyl, and morphine. Drugs commonly used in addiction treatment for opioid addictions, such as methadone and buprenorphine, were not considered in the analysis.
The Danger of Addiction to Opioids
In addition to increased risk of poor health outcomes, the risk of opioid addiction is higher in people who take prescription opioids on a long-term basis. It is not easy to define when long-term use of prescription painkillers changes from appropriate medical care to addiction. Unfortunately, the transition from an initial prescription of opioids to chronic dependency can begin after a very short period of time.
A CDC study from 2017 reported that the sharpest increase in the likelihood of long-term dependency on prescription opioids came at five days after the initial prescription. Another spike in dependency was seen after one month. In general, however, the longer a prescription, the greater the risk of long-term addiction.
Addiction Risks with Other Substances
Long-term opioid use was also associated with other types of addictions. For example, the study published in PDS found a higher risk of alcohol abuse and heroin abuse among people who had been prescribed opioids for long periods. A 2016 study published in Addiction Science & Clinical Practice reported that alcohol misuse among people in medication-assisted addiction treatment for opioid use disorder was common and was associated with greater risk of death.
This means that people who develop opioid abuse disorders and who receive opioid addiction treatment for opioid withdrawal symptoms that includes the use of medications like methadone and buprenorphine run the very real risk of developing alcohol addiction as well.
The Risk of Fatal Overdose with Long-Term Opioid Use
The greatest risk with long-term opioid use, of course, is the risk of fatal overdose. The leading cause of accidental death in America is drug overdose, and opioid overdose has become an enormous problem in the US. As of 2016, opioid overdoses killed more people than firearm accidents and motor vehicle accidents. Oxycodone (Oxycontin) and Hydrocodone (Vicodin) were the two prescription painkillers most likely to be associated with fatal overdose. Overall, estimates for opioid misuse range from 15 percent to 26 percent, which means that around one in five opioid users will develop an addiction.
There is no question that opioid painkillers are highly effective for severe pain due to injuries, surgery, and severe illnesses like cancer. In some people, long-term opioid therapy is appropriate because of the nature of their health conditions. However, the incidence of long-term opioid therapy leading to opioid abuse is high, and it is up to both doctors and patients to weigh the benefits and risks of long-term opioid prescription before embarking on a treatment plan that includes long-term use of opioids.
Effective addiction treatment for opioid abuse exists, but unfortunately, only a fraction of the total number of people with opioid abuse disorders receive addiction treatment. To be successful, addiction treatment must be personalized and must consider the whole person, including his or her other health issues, living situation, career, and many other factors. The good news is that there is no reason to wait. If you are struggling with misuse of opioids, we invite you to learn more about our admissions. There is no obligation, and we sincerely encourage you to reach out today!