A report out this week published in the International Association for the Study of Pain (IASP) scientific journal found that 20-to-30% of opioids prescribed for chronic pain are being misused. It also concluded that the rate of addiction is approximately 10%.
The study was a meta-analysis that combined data of 38 prior studies which were designed to determine the prevalence of opioid misuse.
The way the study was designed caught the eye of Dr. Richard Radnovich, who runs the Injury Care Medical Center in Boise, Idaho which is a leader in clinical research for the treatment of pain.
“While the aim (of the study) is laudable, there are a number of problems with drawing too many conclusions or making policy decisions from this study,” Dr. Radnovich told the National Pain Report.
Statistically speaking, meta-analysis studies are most valuable when the studies included have consistent methodologies, definitions and results.
“Simply put, averaging bad data does not create valid data,” he said.”In this case, methodologies were not consistent, and, most glaringly, the data from previous studies had wildly varying results–going from less than 1% in one study of misuse to about 80% in another.
There is a growing concern among pain professionals and patients that the issues of chronic pain which affects at least 100 million Americans and opioid dependency have merged. The Drug Enforcement Administration decision last year to reschedule hydrocodone combination products to Schedule 2 has put an added emphasis on opioid dependency.
Dr. Steve Passik, Vice President of Clinical Research and Advocacy at Millennium Health was talking about this issue recently with the National Pain Report.
” Where opioids are concerned we dramatically expanded their use and then we went from having one tremendous public health problem, chronic pain to having two by adding the problem of prescription drug abuse and the pendulum has been swinging between the two to try and figure out an effective strategy to keep people with pain treated and to avoid, abuse, addiction, overdose and death.”
Dr. Radnovich struck a similar theme.
There is little doubt that both chronic pain and prescription medication abuse are problems for society. Part of the overall challenge is our lack of understanding of the depth of the problem,” he said. “Invalid over-estimates of misuse do nothing to help understand true addiction or the recreational misuse of opioids. It only serves to further stigmatize the chronic pain patient.
According to a report by the Center for Disease Control, there were over 16,000 deaths involving prescription opioids in 2013, an increase of 1% from 2012. It is estimated that about one in three Americans suffer from chronic pain.
We conducted a longer interview with Dr. Radnovich and will be sharing his thoughts on other issues facing chronic pain sufferers in the coming days.