Scientists Identify Risk Factors for Opioid Dependency and Abuse

Although opioid medications are very effective in managing pain after surgery, injury, or other chronic conditions when prescribed by an overseeing physician, nonmedical use of opioid pain-relieving medications in the U.S. has now surpassed the nation’s levels of abuse of nearly all illicit substances. Doctor shopping and other forms of prescription drug diversion have spread rampantly across all the states—leading to greater prevalence of abuse, dependency, addiction, overdose, and poisoning deaths among all age groups and demographics. While some prescription drug addicts obtain their drugs illegally on the street, from false online prescription markets, or from friends or family members, many addicts actually begin their habit after developing a dependency to their legitimate pain-relieving prescriptions.

Researchers at the Geisinger’s Center for Health Research in Pennsylvania sought to determine if any risk factors for opioid dependency are apparent among individuals receiving opioid therapy following outpatient treatment, as well as the prevalence of abuse among this population. Using patient histories from a large health-care system database, lead researcher Joseph Boscarino and his colleagues identified patients who were prescribed at least four prescriptions for opioid medications within the past 12 months for non-cancer-related pain management. From these health records, the researchers were able to get in touch with a total of 705 of the patients, and interviewed them on their opioid use and other characteristics in order to identify opioid dependency and its possible risk factors. Their study is available in the September issue of the scientific journal Addiction.

For their study, the researchers examined the participants’ DNA to determine whether the presence of a particular gene mutation on chromosome 15—a chromosome associated with alcohol, nicotine, and cocaine addiction—also indicated the presence of opioid addiction. As a result, the researchers found an incident rate for opioid dependence as high as 26% among the study population. Also, the researchers identified several risk factors to be associated with opioid dependency, including age (younger than 65), history of major depression, history of psychotropic medication use, and prior opioid abuse or dependency (such as heroin, codeine, or morphine abuse). When characteristics such as age, depression, psychotropic medication use, and pain impairment were combined, patients’ risk factor for opioid dependence was significantly higher compared to the patients without these characteristics. Just knowing that the patient had a history of prior drug abuse substantially increased their risk of current opioid dependency.

The researchers comment that opioid abuse and dependency may in fact be more prevalent among the U.S. population that previously understood. Before prescribing patients pain-relieving medications, the researchers recommend that health physicians screen patients for these certain risk factors in a clinical evaluation to help avoid potential opioid abuse. By doing so, chronic pain could be treated effectively without the risk of future drug abuse and dependency. Likewise, individuals without a history of chronic pain are just as susceptible to opioid addiction if these preexisting risk factors are present. Lastly, the researchers suggest that these risk factors should be further investigated in future studies on opioid abuse and preventive efforts.

Source: HealthDay, Robert Preidt, Study Identifies Risks for Painkiller Addiction, September 2, 2010

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