High Use of Painkillers Isn't Linked To Addiction

High Use of Painkillers Isn't Linked To Addiction
Posted by FoM on April 06, 2000 at 07:33:43 PT
By Joe Rojas-Burke of The Oregonian Staff 
Source: Oregon Live
The use of morphine and related narcotic painkillers escalated dramatically in Oregon and across the nation in the 1990s, triggering alarm bells for law enforcement agencies concerned about illegal diversion and abuse. But problems of addiction aren't rising with the increasing use of this class of drugs for treating severe pain, concludes a new study, which found that the abuse of opioid painkillers remains rare in comparison with the problems with other abused substances. 
The findings are significant because exaggerated fears of addiction or abuse have played a big part in the widespread undertreatment of pain among cancer patients, nursing home residents and others who can benefit from opioid drugs. "This study shows that the efforts to improve pain management have not resulted in increased abuse," said lead researcher David Joranson of the Pain and Policy Studies Group at the University of Wisconsin Medical School in Madison. "We should view these drugs with respect, but not with fear," Joranson said. The researchers used a database kept by the U.S. Drug Enforcement Administration to track the medical use of morphine and other opioid drugs from 1990 through 1996. The database records the legal distribution of controlled drugs from manufacturers to retail pharmacies, hospitals and clinics. The rate of morphine use jumped more than 49 percent during the seven years, from 868 grams to 1,297 grams per 100,000 population. Use of oxycodone rose 15 percent, and hydromorphone, 12 percent. Consumption of the drug fentanyl rose a staggering 1,100 percent. But experts pointed out that the fentanyl numbers are skewed by the introduction of a skin patch formulation that wasn't available in the United States until 1991. To get an idea of the prevalence of abuse of these drugs, the researchers turned to an ongoing federal survey of 500 hospital emergency departments that make up a nationally representative sample. The survey collects information on each patient treated for an overdose or any other problem linked to drug abuse. During the study period, the number of reports listing morphine increased 3.2 percent, and those mentioning any opioid painkiller increased 6.6 percent. But the number of abuse reports plunged by 15 percent or more for the opioid drugs fentanyl, hydromorphone, meperidine and oxycodone. And all opioid painkillers as a class accounted for a steadily decreasing share of the total number of abuse reports, from 5.1 percent in 1990 to 3.8 percent in 1996. Morphine accounted for less than one-tenth of a percent of abuse reports. Non-opioid pain medicines such as aspirin and ibuprofen sent more people to emergency departments, totaling 8.6 percent of 1996 reports. Illicit drugs such as heroin, cocaine and LSD accounted for 33 percent of abuse reports, and alcohol in combination with other drugs, 18 percent. The study, paid for by a grant from the Robert Wood Johnson Foundation, appears in this week's Journal of the American Medical Association. DEA officials declined to discuss the study, other than to say through a spokeswoman that the increasing use of opiates "is indicative that DEA does not have a problem with pain management. The growth is commensurate with current medical thinking and use in treating pain in an aging population." Experts in the treatment of pain said they hope the study will reassure patients and medical caregivers about the safety of morphine and other opioid drugs as treatments for pain. "There's an enormous amount of mythology and misinformation about these drugs," said Dr. Paul Bascom, a pain management expert and assistant professor of medicine at Oregon Health Sciences University in Portland. He said the risk of addiction is essentially zero in people with no history of drug or alcohol abuse. Studies as far back as 1980 have consistently reached the same conclusion. People taking opioids for pain can develop tolerance and require increasing doses of drugs to keep pain at bay, but studies in recent years have revealed that tolerance rarely gets in the way of effective treatment. Often, researchers have found, the need for more pain medication is a consequence of worsening disease and a rise in pain, not the buildup of tolerance to the drug. The new study found one exception to the rising popularity of opioid drugs for treating pain. Use of meperidine, or Demerol, fell by 39 percent. To Bascom, that shows medical caregivers are being judicious while increasing their overall use of pain medication. Meperidine, a synthetic opioid, has unique qualities that make it the least desirable for long-term treatment of pain: It carries the greatest risk of harmful side effects and is the most prone to abuse. That it is falling from favor "indicates that our education efforts are being heeded and understood," Bascom said. You can reach Joe Rojas-Burke at 503-412-7073 or by e-mail at joerojas news.oregonian.comPublished: Wednesday, April 5, 2000Copyright 2000, Oregon Live ®CannabisNews Articles On Addiction:
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Comment #1 posted by dddd on April 07, 2000 at 00:34:53 PT
An excellent example of a pile of crap,using twisted information from a crooked source,which the DEA is........dddd
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