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Opioid prescriptions double over the last 24 years

New research has found that opioid prescriptions for non-cancer related pain has doubled over the last 24 years.

Academics from the University of Sydney; the University of Warwick, UK; the University of Notre Dame; the University of New South Wales and Monash University, looked at data from eight countries and evaluated 42 published studies that included 5,059,098 people with chronic pain conditions (other than cancer).

The data revealed that between 1991 and 2015, one in three patients were prescribed an opioid medicine and in the early studies, opioid medicines were prescribed to about 20 per cent of patients experiencing chronic pain but the later studies report rates of more than 40 per cent.

“We noted that a higher proportion of people were prescribed a strong opioid medicine such as oxycodone compared to weak opioid pain-relieving medicines,” said lead author Dr Stephanie Mathieson, from the School of Public Health in the Faculty of Medicine and Health at the University of Sydney.

The average age of people prescribed opioids is 55.7 years of age, however the study’s authors noted a significant evidence gap in global data.

The study aimed to establish a baseline for how commonly opioids are prescribed for people with chronic pain conditions (other than cancer). But the authors discovered a lack of prescription data in countries outside of the US.

“While we have sufficient data for this purpose for the US, we have little or no data for other countries,” they wrote.

In the Australian context, data form the Australian Institute of health and welfare shows around 3.1 million people were dispensed opioid prescriptions in 2016–17 and between 2007–08 and 2016–17 there was a 25 per cent rise in the rate of hospitalisations due to opioid poisoning.

The rate of opioid deaths also rose by 62 per cent from 2007 to 2016.

Previous research carried out by Sydney Uni has found that opioid prescription for muscle and joint pain in older people – aged 60 and older – may offer little benefit, and may in fact increase the risk of harmful side-effects.

“Our findings show that in this group opioid painkillers have only a small effect on decreasing pain and improving function, whilst the risk of side effects is high,” said Associate Professor Manuela Ferreira, senior researcher at the Institute of Bone and Joint Research, 

“Patients experienced around a seven per cent decrease in pain compared to placebo pills, which is considered too small to be of clinical importance. Only small improvements on physical function was found.

“We also found that older people taking opioids for musculoskeletal pain are almost three times more likely to have an adverse event associated with treatment. The most common being nausea, constipation, drowsiness, dizziness, headache and dry mouth.

“The impact of these side effects on the older patient can be very significant, leading to more serious events such as falls and confusion.”

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