Among patients who take an opioid, about 1 in 10 develops opioid dependence or opioid use disorder. Nearly one in three shows symptoms of dependence and opioid use disorder, a new report finds.
The report, which was a review of 148 existing studies on more than 4.3 million adult chronic pain patients treated with prescription opioid painkillers, was published Wednesday in Addiction.
Compared with previous calculations, this review is more accurate and shows a more concerning rate of opioid misuse than previously thought, according to researchers at the University of Bristol, funded by the National Institute for Health and Care Research (NIHR).
The authors pointed out that companies like Purdue Pharma, which makes Oxycontin, say that less than 1% of opioid prescriptions result in problems for patients. This new review makes clear that such claims greatly understate the risk of opioid misuse and addiction, according to a statement on the report.
The researchers divided the 148 studies into four general categories. There were 43 studies on dependence and opioid use disorder. In those studies, the prevalence of problematic opioid use was 9.3%. The second category comprised 44 studies on signs and symptoms of dependence and opioid use disorder; 29.6% of people in those studies were affected. In the third category, a total of 76 studies evaluated inappropriate behavior (like getting refills early) and found 22% of people had problematic opioid use. In the last category, a total of eight previous studies looked at what qualities may increase a person’s risk for opioid dependence or opioid use disorder. In that category, the prevalence of opioid-related problems was 12.4%.
Some studies reported data based on the same participants using different criteria, the authors pointed out.
“Clinicians and policy makers need a more accurate estimate of the prevalence of problematic opioid use in pain patients so that they can gauge the true extent of the problem, change prescribing guidance if necessary, and develop and implement effective interventions to manage the problem. Knowing the size of the problem is a necessary step to managing it,” Kyla Thomas, PhD, a professor of public health medicine at the University of Bristol and lead author, said in the same statement.
Studies were mostly based on data from North American research and high-income countries. Of the 148 studies, 106 were conducted between 2010 and 2021; the oldest study was from 1985.
