As Opioid Use Soars, No Evidence of Improved Treatment of Pain
The authors of a new study from Johns Hopkins report that prescriptions for opioid medications have skyrocketed in the last decade, while pain identification and management has largely stayed the same. Opioid addiction and overdose are also on the rise. The results of this study come at an interesting time, as the FDA just recently announced more stringent labeling for extended-release opioid medications, urging that prescriptions for these medications be restricted to management of only the most extreme cases of round-the-clock chronic pain. Many have viewed this move by the FDA as an attempt at addressing the opioid addiction problem in the USA. However, what effect this will have remains to be seen, and some are not so convinced that it will have any effect at all.
As Opioid Use Soars, No Evidence of Improved Treatment of Pain
September 16, 2013
A new study led by the Johns Hopkins Bloomberg School of Public Health finds that during a decade when prescription opioid use has skyrocketed, the identification and treatment of pain has failed to improve, and the use of non-opioid analgesics has plateaued, or even declined. The study was published online September 13 in the journal Medical Care.
"There is an epidemic of prescription opioid addiction and abuse in the United States," notes G. Caleb Alexander, MD, MS, associate professor of Epidemiology and Medicine and co-director of the Johns Hopkins Center for Drug Safety and Effectiveness. "We felt it was important to examine whether or not this epidemic has coincided with improved identification and treatment of pain."
Alexander and his fellow researchers used the National Ambulatory Medical Care Survey, designed by the CDC/National Center for Health Statistics, to analyze trends from 2000 to 2010 associated with patients seeking medical treatment for non-cancer pain. They found no significant change in the proportion of pain visits – approximately one-half - treated with pain relievers.
During this time, non-opioid (analgesic) prescriptions remained stable, consisting of 26-29 percent of pain visits. However, opioid (morphine-related) prescriptions nearly doubled, from 11 percent in 2000 to 19 percent in 2010. Of approximately 164 million pain visits in 2010, roughly half were treated with some kind of pain relieving drug: 20 percent with an opioid and 27 percent with a non-opioid pain reliever.
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