Extended-release opioids: 29% of patients become long-term users

  • Young JC & al.
  • Pain Med
  • 24.07.2019

  • von Kelli Whitlock Burton
  • Clinical Essentials
Der Zugang zum gesamten Inhalt dieser Seite ist nur Angehörigen medizinischer Fachkreise vorbehalten. Der Zugang zum gesamten Inhalt dieser Seite ist nur Angehörigen medizinischer Fachkreise vorbehalten.

Takeaway

  • 29% of patients receiving extended-release (ER) opioids became long-term users; the most common noncancer-related indications for use were back pain and arthritis.
  • ER opioids approved within the last 10 years were more likely prescribed for noncancer-related pain.

Why this matters

  • Information about the diagnoses that led to long-term opioid use will inform efforts to design strategies to deter that long-term use.

Study design

  • This study identified 1,041,628 adults initiating ER opioid therapy (≥120 days of enrollment) from MarketScan databases (2006-2015).
  • Funding: None disclosed.

Key results

  • 29% adults (n=298,405) were long-term users (≥90 days) of ER opioids; median length of prescribed use was 200 days.
  • Back pain (65.8%) and arthritis (49.4%) were the most common pain diagnoses for ER opioid initiation.
  • Among the long-term ER opioid users:
    • 16% had procedure/diagnosis for cancer,
    • 88% had noncancer-related chronic pain, and
    • 9% had no pain-related diagnosis.
  • Oxycodone (32% of initiators), fentanyl (21%), and morphine (18%) were commonly prescribed ER opioids at initiation.
  • Evidence of cancer was seen in 16% vs 9% of patients when the drug was approved >10 years ago vs within 10 years, respectively.

Limitations

  • Findings may not be generalizable.
  • Out-of-pocket transactions may have been missed.

Coauthored with Chitra Ravi, MPharm