Reports From The Field-Pain management
Reports From The Field-Pain management
Study finds opioid use increasing in pain treatment
Researchers find no increase in opioid abuse
A retrospective study of six years worth of medical records published recently in The Journal of the American Medical Association found that opioid use to treat pain is increasing in the United States without any apparent increase in opioid abuse.
Researchers reviewed medical records from 1990 to 1996 stored in the databases of the Drug Abuse Warning Network and the Automation of Reports and Consolidated Orders system. They identified a nationally representative sample of hospital emergency department admissions resulting from drug abuse. Researchers discovered that medical use of:
• morphine rose 59% from 2.2 million g in 1990 to 3.5 million g in 1996.
• fentanyl rose 1,168% from 3,263 g to 41,371 g.
• oxycodone rose 23% from 1.6 g to 2 g.
• hydromorphine rose 19% from 118,455 g to 141,325 g.
• meperidine declined 35% from 5.2 million g to 3.4 million g.
During the same period, researchers found the total number of drug abuse mentions per year due to opioid analgesics increased only 6.6% from 32,340 to 34,563. They found that reports of abuse of:
• meperidine decreased 39% from 1,335 g to 806 g.
• oxycodone decreased by 29% from 4,526 g to 3,190 g.
• fentanyl decreased 59% from 59 g to 24 g.
• hydromorphine decreased 15% from 718 g to 609 g.
• morphine increased by 3% from 838 g to 865 g.
Researchers concluded that the trend of increasing medical use of opioids to treat pain does not appear to contribute to increases in the health consequences of opioid abuse.
[See: Joranson DE, Ryan KM, Gilson AM, Dahl JL. Trends in medical use and abuse of opioid analgesics. JAMA 2000; 283:1,710-1,714.]
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