Growing pains: Long-term opioid prescriptions lead to addiction in 1/3 patients

A survey of 809 adults who have been prescribed opioids for long-term use or have a long term opioid user in their household, found that one in three are dependent on opioids. The vast majority were prescribed opioids by their doctors.

Much of the US is in the throes of an opioid epidemic, and the blame has been placed with federal regulators of pharmaceuticals, to the doctors prescribing the painkillers, to the industry itself. But a Washington Post-Kaiser Family Foundation survey released Thursday offers insight into the development of opioid addiction as well as what doctors should be doing better to reduce dependency.

The survey examined the experience of people who had been taking opioids for over two months to treat pain not related to cancer or terminal illness. The need to use painkillers for long periods of time can range from degenerative diseases like arthritis to injuries that are unlikely to heal.

However, 35 percent of people surveyed by the Post were not informed by their doctors of the possibility of addiction or dependency. In addition, 38 percent were never given alternative options for pain management. More startlingly, 61 percent of users were not given a plan for getting off the medication.

Discontinuing painkillers can have harsh side effects, such as anxiety or diarrhea. Director of the US Centers for Disease Control and Prevention (CDC) Tom Frieden has been pushing for doctors to limit the amount of pills they prescribe. He told the Post that “prescription opiates are as addictive as heroin.”

“You take a few pills, you can be addicted for life. You take a few too many and you can die,” Frieden added.

Forty-five percent of those surveyed were no longer taking drugs, and only 3 percent had started using opioids as recreational users.

This is not meant to diminish the good that some opioids can do for certain people, such as a 74-year-old bricklayer who told the Post that he owes his ability to walk to his painkiller after his career took its toll on his knees.

Rather, the survey of patients reveals certain gaps between some medical professionals and their patients. While the majority of those polled said their doctors had warned them about the risks of consuming alcohol while on painkillers and other possible side effects, nearly half of the long-term users said their doctors never altered their dosage or the frequency of their medication.

Six out of 10 people who identified as being addicted did not seek treatment or help.

Going forward, the CDC is urging doctors to avoid prescribing narcotics for more than 12 weeks and to try non-narcotic methods first. Doctors are also re-examining how they prescribe opioids. Patrice A. Harrison, of the American Medical Association’s Board of Trustees and chair of the task force to reduce opioid abuse, told the Post, “The doctors that I have talked to are discussing this with their patients.”

“We could certainly do a better job,” Harrison acknowledged.