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Opioid dependence can start in just a few days

Opioid dependence
Big problem   A single day with a narcotic painkiller

Doctors who limit the supply of opioids they prescribe to three days or less may help patients avoid the dangers of dependence and addiction, a new study suggests.


Among patients without cancer, a single day's supply of a narcotic painkiller can result in 6 percent of patients being on an opioid a year later, the researchers said.

The odds of long-term opioid use increased most sharply in the first days of therapy, particularly after five days of taking the drugs.

The rate of long-term opioid use increased to about 13 percent for patients who first took the drugs for eight days or more, according to the report.

"Awareness among prescribers, pharmacists and persons managing pharmacy benefits that authorization of a second opioid prescription doubles the risk for opioid use one year later might deter overprescribing of opioids," said senior researcher Martin Bradley.

He is from the division of pharmaceutical evaluation and policy at the University of Arkansas for Medical Sciences.

"The chances of long-term opioid use, use that lasts one year or more, start increasing with each additional day supplied, starting after the third day, and increase substantially after someone is prescribed five or more days, and especially after someone is prescribed one month of opioid therapy," Bradley said.

The odds of chronic opioid use also increase when a second prescription is given or refilled, he noted.

People starting on a long-acting opioid or tramadol (Ultram) were more likely to stay on opioids than those given hydrocodone (Vicodin) or oxycodone (Oxycontin), Bradley said.

The highest probability of continued opioid use at one and three years was seen among patients who started on a long-acting opioid, followed by patients who started on tramadol, he said.

 

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