Patients who reduced the dose of opioids for chronic pain had more overdoses, mental health problems
Patients who received opioid therapy to treat chronic pain and who had their dose reduced saw an increase in overdoses and mental health events, a new study finds.
Researchers from the University of California, Davis, analyzed data from 113,618 patients who used opioids to manage pain from cancer, accidents and other illnesses.
They looked at doctors administering a treatment called tapering, in which the amount of opioids is slowly reduced over time.
The team found that those who slowly tapered their opioid use were nearly 70 percent more likely to overdose and even twice as likely to have a psychological incident than others.
The data raises questions about what the most effective treatments for pain relief really are and whether some treatments can inadvertently cause harm.
Researchers found that patients who received opioid therapy for pain relief and who used ‘tapering’ as part of their treatment were 68% more likely to have an overdose and more than twice as likely to have a mental illness
“Our study shows an increased risk of overdose and mental health crisis after dose reduction,” Alicia Agnoli, assistant professor at the UC Davis School of Medicine and lead author of the study, said in a release.
“It suggests that patients undergoing taper require significant support to safely reduce or discontinue their opioids,”
The team, which published findings in JAMA on Tuesday, collected data from patients who received long-term, high-dose therapy for chronic pain.
Of the 113,000 participants, 29,101 participated in tapering.
Among those who took tapering as part of their treatment, there were an average of 9.3 overdose cases for every 100 years of treatment, a 68 percent jump from the 5.5 per every 100 years of treatment for others.
There were also 7.6 mental health events — such as being diagnosed with depression, anxiety or suicide attempt — per 100 years of treatment in those taking tapering, more than double the 3.3 per 100 years for the others.
Researchers suggest that their data shows that patients participating in tapering require more monitoring and follow-up appointments than they currently receive.
We hope this work will lead to a more cautious and compassionate approach to opioid dose tapping decisions,” Agnoli said.
“Our study can help shape clinical guidelines for patient selection for tapering, optimal dose reductions, and how best to monitor and support patients during dose transition periods.”
The Department of Health and Human Services recommends doctors make regular contact with patients undergoing opioid treatments, as the regular contacts could deter them from reaching for illegal versions of the drugs.
“I’m concerned that most taper patients don’t get close follow-up and monitoring to make sure they’re doing well on lower doses,” said Joshua Fenton, the study’s senior author and vice chair of research at the Family Department. and Community Medicine at UC Davis.
Opioid addiction has become a huge but underreported killer in the United States.
Opioids were responsible for nearly 70,000 deaths in the US last year as the pandemic caused a record number of overdose deaths
Preliminary CDC data shows that 93,331 drug overdose deaths were recorded in the U.S. in 2020, a 29.4% increase from 72,151 deaths reported in 2019. Opioids were responsible for nearly 70,000 of the deaths
Last year, the country recorded a record 93,000 overdose deaths – a 30 percent increase from the previous year – with nearly 70,000 deaths from opioids.
Many Americans become addicted to opioids after receiving the drug legally, before eventually turning to illegal drugs like heroin or fentanyl to get their fix.
Fentanyl, a synthetic version of the drug, is believed to be the leading cause of opioid-related addictions.
The pandemic was especially troubling as many undergoing treatment for addiction had their programs interrupted, potentially causing them to relapse and overdose.
The COVID-19 pandemic also caused long periods of social isolation for many, opening the door for people to become addicted to the drugs.
HOW AMERICA BECAME ADDICTED TO OPIOIDS
Prescription opioids and illegal drugs have become incredibly ubiquitous in the US, and things are only getting worse.
In the early 2000s, the FDA and CDC began to notice a steady increase in opioid addiction and overdose cases. In 2013, they issued guidelines to curb addiction.
However, that same year — now considered the year the epidemic spread — a CDC report revealed an unprecedented rise in opioid addiction rates.
Overdose deaths are now the leading cause of death among young Americans — more deaths in a year than ever were killed annually from HIV, gun violence or car accidents.
In 2019, the CDC revealed that nearly 71,000 Americans died of drug overdose.
This is an increase from about 59,000 just three years earlier, in 2016, and more than double the death rate from ten years ago.
It means that drug overdoses are currently the leading cause of death for Americans under the age of 50.
The data exposes the bleak state of the US opioid addiction crisis, fueled by deadly manufactured drugs like fentanyl.