July 2, 2015

New Research Finds First-Time Rx Painkiller Prescriptions Tend to be Refilled Again and Again

Mayo Clinic researchers have found that one in four people who were taking prescription painkillers for the first time progressed to long-term prescriptions.

The study, “Incidence and Risk Factors for Progression From Short-term to Episodic or Long-term Opioid Prescribing,” also found that people with histories of tobacco use and substance abuse were likeliest to use opioid painkillers long-term.

“But discovering who is likeliest to end up using the drugs long-term is critically important due to the widespread problems associated with their misuse, said lead author W. Michael Hooten, M.D., an anesthesiologist at Mayo Clinic in Rochester, in a news release.

“From a patient perspective, it is important to recognize the potential risks associated with these medications. I encourage use of alternative methods to manage pain, including non-opioid analgesics or other non-medication approaches,” Hooten said. “That reduces or even eliminates the risk of these medications transitioning to another problem that was never intended.”

Researchers used the National Institutes of Health-funded Rochester Epidemiology Project to get a random sample of 293 patients who received a new prescription in 2009 for an opioid painkiller such as oxycodone, morphine, hydromorphone, oxymorphone, hydrocodone, fentanyl, meperidine, codeine and methadone.

The neurobiology related to chronic pain, chronic opioid use and addiction is similar, Hooten wrote. For example, nicotine activates a group of receptors, or brain structures, in a way very similar to how opioids and chronic pain may activate them.

If opioids must be used, as is usually the case with surgery or traumatic injuries, reducing the dose and limiting the duration of use is important. The next step in this research is to drill down and find more detailed information about the potential role of dose and quantity of medication prescribed,” Hooten added. “It is possible that higher dose or greater quantities of the drug with each prescription are important predictors of longer-term use.”

Their findings are published in the July issue of the medical journal Mayo Clinic Proceedings.


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