Nicotine use, substance abuse associated with long-term opioid use

Nearly one-fourth of patients who are prescribed opioids will progress into long-term prescribers, with those who have a history of nicotine use and substance abuse being more likely to continue using opioids, according to recently published data. 

“Many people will suggest it’s actually a national epidemic. Many people now are experiencing fatal overdose related to opioid use than compared to heroin and cocaine combined,” W. Michael Hooten, MD, department of anesthesiology, Mayo Clinic, Rochester, said in a press release.

Hooten and colleagues analyzed the 2009 medical records of 142,377 individuals residing in Olmsted County, Minnesota, to quantify the number of patients who go from newly prescribed opioid patients to episodic or long-term users. 

In total, 515 opioid prescriptions were written for 293 patients. Most commonly, opioids were prescribed for surgery or other painful procedures, musculoskeletal pain and trauma. Over 60% of those who received a prescription were women.

Twenty-one percent of patients progressed into episodic prescribers, and 6% progressed into long-term prescribers. 

Results demonstrated that long-term opioid prescribing patterns were strongly associated with substance abuse (P < .001). Compared with short-term prescribing patterns, patients who progressed to long-term or episodic prescription patterns were more likely to have a history or current use of nicotine (P = .03) and substance abuse (P = .04).

The researchers urged the importance of identifying what clinical characteristics are associated with long-term and episodic use of opioids to determine the best interventions and alternative therapies for high-risk individuals.

“The next step in this research is to drill down and find more detailed information about the potential role of dose and quantity of medication prescribed. It is possible that higher dose or greater quantities of the drug with each prescription are important predictors of longer-term use,” Hooten said in the press release. – by Casey Hower 

Disclosure: Healio.com/Family Medicine was unable to confirm relevant financial disclosures at the time of publication.