Opioid Therapy: When Use Becomes Abuse

Dr. Mark Borigini Health Guide
  • An article recently appeared in the July, 2007 issue of "The Journal of Pain." And I found it one of the few scholarly medical articles which appeared as disturbing as it was interesting.


    Interesting, because the study confirmed what many have assumed for a long time: There is a pervasive abuse of prescription narcotics.


    Disturbing, because the study confirmed what many have assumed for a long time: There is a pervasive abuse of prescription narcotics.


    For many, the treatment of chronic pain involves long-term narcotic (opioid) treatment. However, as has been widely reported in the media as of late, there is increasing concern of abuse of these drugs. OxyContin has been in the news lately, and Vicodin is often involved in some headline regarding the latest celebrity trip to rehab.

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    The study mentioned above sought to establish just how prevalent the abuse of opioid pain medication is when it is prescribed by the family doctor. It examined the primary care practices of 235 family physicians and internal medicine doctors in Wisconsin, focusing on 801 adults receiving daily opioid therapy. In general these were patients suffering from common causes of pain: degenerative joint disease, low back pain, migraines, neuropathy, and fibromyalgia.


    Utilizing well-established criteria for diagnosing substance abuse, dependence, and opioid use disorder, the researchers found the prevalence of substance abuse and/or dependence to be almost 10%; the prevalence of opioid use disorder was almost 4%. By way of comparison, the prevalence of opioid use disorder in the general population is less than 1%.


    It was found that younger patients (ages 18 to 30) were more at risk for such substance abuse, as were those patients with past psychiatric illness and/or drug abuse (marijuana or cocaine, for example).


    Further, the rate of positive tests for illicit drug use was 24%. And many patients were not being honest with the researchers, as it was found that almost 50% with positive lab tests for illegal drug use actually denied illegal drug use--even when they were guaranteed they would remain anonymous.


    So, how do we stop the abuse of these prescribed drugs? An article in the June 19, 2007 edition of "Annals of Internal Medicine" addresses "Strategies to Stop Abuse of Prescribed Opioid Drugs."


    But you will have to read my next blog to find out more.

Published On: October 01, 2007