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Opioids and addiction

Addiction is considered one of the main risks of taking opioid pain medication, but policy-makers and the media have massively inflated that risk.

the truth is that addiction is very rare in the chronic pain community. The vast majority of chronic non-cancer pain patients take their opioid pain-relieving medications exactly as directed, and do not become addicted.

Opioids, when taken for severe pain, do not induce euphoria, they reduce the pain to a managable level which allows the chronic pain patient to work, socialise and contribute to their community.

Please see the studies below that address the risk and rate of addiction in the chronic pain community.

Published: April 2022

Opioid-related overdose and chronic use following an initial prescription of hydrocodone versus oxycodone

https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0266561

And our write up here: https://painpatientadvocacy.org/study-opioid-related-overdose-and-chronic-use-following-an-initial-prescription-of-hydrocodone-versus-oxycodone/

This study was comparing oxycodone to hydrocodone to see which resulted in more overdoses and addiction (persistent use). What the study very clearly found was that overdose was very rare with either medication. Infact only 2.8% of patients, in a sample of 14, 458 patients, developed chronic use (addiction). But they do not report this in their conclusions.

This study is a very good example of how researchers cherry-pick their own data and only report on those parts of the study that support the conclusions and narrative that they are setting out to prove. Their conclusion did NOT mention the incredibly low overdose rate, and addiction rate that this study found, deciding to only comment on which medication, oxycodone or hydrocodone, was more or less additive or resulted in more overdoses. This is a deceptive practice, and any ethical researcher would have made clear in the conclusion that both overdose and addiction are very, very rare.

Their conclusion: “Among previously opioid-naïve patients, the risk of developing chronic use was slightly higher with hydrocodone, whereas the risk of overdose was higher after oxycodone, in combination with acetaminophen or monotherapy. With a goal of reducing overdose-related deaths, hydrocodone may be the favorable agent.”

Published March 2021

Initial opioid prescription patterns and the risk of the ongoing use and adverse outcomes

https://pubmed.ncbi.nlm.nih.gov/33300138/

This study looked at patients who were prescribed an opioid for pain and examined how many people continued to take them long-term (3.17%) and how many experienced an opioid overdose (0.055%).

Its clear that opioid the vast majority did not continue taking their opioid pain reliving medications after their pain had resolved, and did not develop an addiction, which is contrary to the media narrative that most addicts start with a prescription for opioids and that opioids are so addictive, so dangerous, that no one can resist. It is clear that the risk of addiction from opioids when taken as prescribed for pain (acute or chronic) is very low (3.17%)

From the study: “Among the 2,021,371 individuals meeting our inclusion criteria, 1121 (or 0.055%) experienced an opioid overdose within 1 year and 64,013 (3.17%) continued treatment for at least 1 year. “

You can find more on the study here: https://painpatientadvocacy.org/initial-opioid-prescription-patterns-and-the-risk-of-ongoing-use-and-adverse-outcomes/

Published online: 04 May 2017 Canadian Journal of Pain Vol 1, 2017

“One Size Fits All” Doesn’t Fit When It Comes to Long-Term Opioid Use for People with Chronic Pain

https://www.tandfonline.com/doi/full/10.1080/24740527.2017.1319733

This is an extremely thorough study which examines the rates of overdose and and addction, finds that

“Stopping appropriate medical prescribing of opioids will not stop people with addiction from abusing opioids and will cause significant collateral damage to people with pain”

The study’s conclusion: Statistics from the 2015 US National Survey on Drug Use and Health18 are also revealing for what they say about addiction to prescription pain relievers. The survey, comprising 68,073 face-to-face interviews, showed that 36.4% of the US population over the age of 12 years reported using prescription pain relievers and 4.7 % reported misusing them in the past year. Note, that the definition of misuse includes “use in any way not directed by a doctor, including … use in greater amounts, more often, or longer than told to take a drug …” (ref. 18, p. 9). Among the 4.7% who misused prescription pain relievers, the most common reason given for the misuse was “to relieve pain” which was reported by 62.6% of respondents with only 2.3% endorsing “because I am hooked or have to have it.” Using these numbers, it is estimated that ~0.12% of the population of the United States over the age of 12 years is addicted to prescription pain relievers.

Read more: https://painpatientadvocacy.org/study-one-size-fits-all-doesnt-fit-when-it-comes-to-long-term-opioid-use-for-people-with-chronic-pain/

First published: 09 January 2012

Appropriate and responsible use of opioids in chronic non-cancer pain

https://onlinelibrary.wiley.com/doi/full/10.1016/S1090-3801%2802%2900144-1

In 2012 a group of distinguished pain clinicians from nine European countries got together to discuss the appropriate use of strong opioids for chronic non-cancer pain. These people are all at the top of their field and their conclusions and recommendations are drawn from vast clinical experience. That is ‘real world’ experience from caring for actual patients.

All agreed that while treating chronic noncancer pain with opioids was not without risk, some patients for whom all other therapies have failed can be safely and effectively treated with strong opioids. These patients experience reduced pain and improved quality of life where no other therapy delivers these benefits. Only a minority of patients will qualify, but strong opioids must not be denied these patients and guidelines should reflect such.

read more here: https://painpatientadvocacy.org/study-appropriate-and-responsible-use-of-opioids-in-chronic-non-cancer-pain/

Published: May 2007

Long-term use of controlled-release oxycodone for noncancer pain: results of a 3-year registry study

https://pubmed.ncbi.nlm.nih.gov/17449988/

This study was to evaluate the outcomes associated with the use of controlled-release (CR) oxycodone for up to 3 years in the treatment of noncancer pain. It is an older study, and a small study, with only 233 participants, It is still very important, however, because there are very few long-term studies on the effects of long-term opioid therapy on chronic non-cancer pain.

This study clearly finds that for the majority of patients in this study, long-term opioid therapy provided sustained pain relief, with little need for dose increases. There were no serious side effects and the side effects waned over time. Most importantly of all, there were NO cases of addiction or overdose, which is the reason most often used for non-prescription and/or involuntary tapering of chronic non-cancer pain patients off opioids.

read more here: https://painpatientadvocacy.org/study-long-term-use-of-controlled-release-oxycodone-for-noncancer-pain-results-of-a-3-year-registry-study/

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