Painkillers not as addictive as feared: Study

Reuters, Sunday 4 Nov 2012

New analysis of past research suggests that prescription painkillers might not be as addictive as once thought

Fewer than five percent of patients prescribed narcotics to treat chronic pain become addicted to the drugs, according to a new analysis of past research. 

The finding suggests that concerns about the risk of becoming addicted to prescription painkillers might be "overblown," said addiction specialist Dr. Michael Fleming at Northwestern University's Feinberg School of Medicine.

"If you're a person that doesn't have a history of addiction and doesn't have any major psychiatric problems, narcotics are relatively safe as long as your doctor doesn't give you too much and uses the right medication," Fleming, who was not involved in the new study, told Reuters Health.

Some recent research has concluded the same thing, but another expert remained skeptical about the new report because many of the studies it included were not considered the best quality research, and they varied widely in their results.

"I think the jury's still out" on how worrisome prescription opioid addiction is, said Joseph Boscarino of the Geisinger Clinic in Danville, Pennsylvania, who studies pain and addiction.

Opioid painkillers, which include oxycodone, fentanyl and morphine, have only recently become available for patients with chronic pain, said Boscarino, who was not part of the new study.

In the past, the drugs were almost exclusively reserved for cancer patients and people with short-term pain, on the theory that in the first category of patients the need outweighed the risk, and in the second group, short-term use was unlikely to lead to long-term addiction. 

To get a sense of how addictive opioid painkillers are for those patients who do have a prescription, researchers from The Cochrane Collaboration, an independent group that reviews research on medications, collected the results from 17 studies covering more than 88,000 people.

All of the patients had been prescribed opioids to treat chronic pain, and nearly all of them had pain unrelated to cancer.

In 10 of the studies, patients used the painkillers for anywhere from three months to several years, while one study included just short-term use of several days and the others did not report the length of time patients were on the drugs.

Taken together, the studies found that 4.5 percent of people developed a dependency on the painkillers.

"It's a low percentage," said Dr. Silvia Minozzi, lead author of the study and a member of the Cochrane Drugs and Alcohol Group in Rome. 

Minozzi's review found that, among the  studies with information on substance abuse, people with a history of drug use were more likely than other patients to develop an addiction to their prescription pain pills.

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