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Alison Rodriguez
The increasing trend in long-term prescription opioid use in the United States calls for further research on the potential benefits and harm, according to a study.
The increasing trend in long-term prescription opioid use in the United States calls for further research on the potential benefits and harm, according to a study.

A study published in Pharmacoepidemiology & Drug Safety investigated the trends and correlations between prescription opioid use and long-term opioid use in the United States. The researchers used data from the National Health and Nutritional Examination Survey (NHANES), a nationally representative survey of the US general population from 1999 to 2014, for information on 47,356 adult participants.

Each participant was interviewed in order to identify the prescription opioid medications they used in the past 30 days. The study also considered the length of time the participant had been taking the medication and if they were taking multiple opioids. If the length of use was fewer than 90 days, the opioid utilization was categorized as short-term, while 90 or more days was considered long-term use.

“Beginning with NHANES 2013‐2014, participants were asked about the main ‘reason’ for using each medication,” the authors explained. “For this study, these reasons were combined into 9 broad categories: back pain; other arthritis and joint pain; injury‐related pain; muscle and soft‐tissue pain; neuropathic pain; head, face and neck pain; upper respiratory infections; other specific conditions; and unspecific pain.”

The researchers used the interviews to analyze the use of benzodiazepine medications, disability due to painful conditions, chronic health conditions, the use of health services, and alcohol use among the participants.

Of the 47,356 adult participants, 2486 reported using opioid prescriptions in the past 30 days.  Additionally, the prevalence of prescription opioid use had increased from 4.1% of adults in the US in 1999 to 2000 to 6.8% in 2013 to 2014. The long-term opioid use also increased from 1.8% to 5.4%, ass 79.4% of opioid users in 2013 to 2014 were long-term users—compared to only 45.1% in 1999 to 2000.  Long-term opioid utilization was also linked to poor physical health, concurrent benzodiazepine use, and a history of heroin use.

“The finding of a growing trend in long‐term use of prescription opioids highlights the urgent need for research regarding the potential benefits and harms of this treatment approach and identifying patient groups for whom the benefits would outweigh the risks. While awaiting such evidence, increased vigilance in prescribing and monitoring of patients who receive long‐term opioid treatment is called for,” the authors concluded. “Such monitoring is especially indicated in patients who are at higher risk of substance use disorder and other adverse health outcomes.”

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