Over Half of Americans Starting Opioids May Be Receiving Inappropriate Treatment

Over Half of Americans Starting Opioids May Be Receiving Inappropriate Treatment
Kyle Walburg, Pharm.D., North Memorial Camden Clinic

Researchers from the Mayo Clinic studying use of opioids in the United States not only found opioid overprescribing, but found that overprescription of high-potency opioids has likely influenced the opioid epidemic.

While it is important to note that certain extended-release or stronger opioids may be clinically necessary at times, they carry with them potential serious risks or side effects. The Mayo Clinic researchers were interested to see if tolerance played a factor in these prescriptions. Researchers examined de-identified claims data and linked electronic health records to determine appropriateness of use. Hospitalized patients, those with an opioid poisoning diagnosis within the previous six months, or those without six months of continuous insurance claims at the time of the prescription were excluded from the study.

Of the nearly 300,000 high-potency prescriptions evaluated in a 10-year period, less than half of patients showed evidence of prior opioid tolerance. The researchers found this concerning, because without previous opioid exposure, these patients are at arguably higher risk for side effects. Researchers speculated that some clinicians may have made these decisions out of necessity, such as using fentanyl patches for patients that could not swallow pills; however, a supporting rationale was not found in the chart upon further review.

These results are important to draw attention to the ideal that healthcare workers are expected to do no harm. When prescribing opioids, the balance of harm and benefit must be carefully considered.

References:

  1. Study: Over Half Of Americans Starting Opioids May Be Receiving Inappropriate Treatment. Pharmacy Times; April 20, 2020. https://www.pharmacytimes.com/news/study-over-half-of-americans-starting-opioids-may-be-receiving-inappropriate-treatment. Accessed May 1, 2020.

  2. Prescribing An Overdose: A Chapter In The Opioid Epidemic [news release]. Mayo Clinic; April 15, 2020. https://newsnetwork.mayoclinic.org/discussion/prescribing-an-overdose-a-chapter-in-the-opioid-epidemic/.Accessed May 1, 2020.