Opiate Painkiller Dependence Myth Debunked: Painkillers Prescribed After Major Injury Do Not Lead To Long-Term Use

The misuse of painkillers is a growing concern in the United States. However, a new study shows that about three out of four patients who suffer from a major trauma and receive a new prescription for an opiate pain reliever discontinue the use of the drug almost a month after discharge.

According to the results of the study presented at the 2016 Clinical Congress of the American College of Surgeons, only about a percent of trauma patients have been reported to still use prescription opiates, or opioids, such as hydrocodone, oxycodone, morphine, and fentanyl, a year after their discharge.

"We were really surprised by how low the numbers were for long-term opiate use," reported senior investigator Andrew Schoenfeld, MD, an orthopedic surgeon at Brigham and Women's Hospital and assistant professor at Harvard Medical School, Boston in a press release. "It appears that traumatic injury is not the main driver for continued opioid use in patients who were not taking opioids prior to their injuries," reported Medical Daily.

According to Medical Xpress, for the study, researchers used the 2007 to 2013 database of the Department of Defense health care system. It included patients aged between 18 and 64 years, who have suffered severe injuries, as indicated by an Injury Severity Score of 9 or higher. Dr. Schoenfeld explained that patients who have experienced major trauma are expected to be given opiate prescription after they are discharged from the hospital.  

It was also stated in an analysis expanded after submission of the abstract and presented at Clinical Congress, investigators included 15, 369 patients. Investigators also reported that none of the patients had filled an opiate prescription six months prior to their injuries.

Even though more than 50 percent of the patients in the study, 8,282, filled at least one opiate prescription soon after they got discharged, the investigators reported that only 8.9 percent (1,371 patients) continued to fill their opiate prescription three months later. Continued prescription opiate use reportedly dropped to 3.9 percent (597 patients) at six months and 1.1 percent (175 patients) at one year.

Meanwhile, a report in the Harvard Health Newsletter stated that the researchers also measured the effect of several other factors on the possibility to continue opiate painkiller use. They used age as an example. According to the report, older patients were more likely to continue using painkillers than young adults.

The report also said stated that lower socioeconomic status increases the use of the medication. Furthermore, marriage was also identified to be one of the factors that showed an increased likelihood of married patients continuing opiate use for longer.

"We wish to emphasize that health care providers should not withhold opiate painkillers because a patient has any of the identified risk factors from this study," Dr. Schoenfeld said. "At-risk patients can benefit from closer follow-up with their health care providers and, for those at high risk, a referral to the hospital's pain management service."