Risk of Opioid Use Becoming ‘Long Term’ Rises Within Days

A new study published in Morbidity and Mortality Weekly Report reveals that the risk for long-term opioid use—defined as use that lasts for at least 1 year—increases within just a few days of starting to take a prescribed opioid drug. Researchers at the Centers for Disease Control and Prevention looked at data reflecting the care of more than a million patients who received at least one opioid prescription between June 1, 2006, and September 1, 2015. Patients with cancer and those with a substance use disorder were disqualified from the study. In addition, the study did not account for the cause or intensity of patients’ pain. All told, 2.6% of the study population used opioids for longer than a year. Those patients were more likely than others to be female; older, on average; enrolled in a public health plan or to be self-insured; have been prescribed a long-acting opioid and diagnosed with pain before they started using opioids; and begun using opioids at a higher prescribed dosage. The rate of long-term opioid use grew to 13% in individuals whose first episodes of opioid therapy lasted for at least 8 days, and to 30% in those whose first episodes of opioid therapy lasted for at least 31 days, underscoring the importance of taking a thorough history. The researchers also stressed that the greatest risk increase occurred in patients who received an initial prescription for more than 10 to 30 days, and those who were prescribed an opioid with a cumulative dose of ≥700 mg of morphine equivalents—both factors that speak to limiting the days’ supply and dosage in the urgent care setting, with recommendation to follow up as needed if pain persists.