Seniors' Long-Term Use of Strong Painkillers a Concern
MONDAY March 12, 2012 -- Older patients prescribed narcotic painkiller drugs, such as codeine or oxycodone, soon after short-stay surgery are at increased risk of becoming long-term users, a new study finds.
Canadian researchers looked at data from almost 400,000 patients aged 66 and older who had short-stay surgery for cataracts, gallbladder removal, prostate tissue removal or varicose vein stripping.
Of those patients, almost 28,000 (more than 7 percent) were prescribed narcotic painkillers, also called opioids, within seven days after hospital discharge. More than 30,000 (nearly 8 percent) were prescribed opioids one year after surgery. Almost 3,000 (more than 10 percent) of patients from both groups were identified as long-term opioid users one year after surgery.
Patients who received an opioid prescription within seven days of surgery were about 44 percent more likely to become long-term opioid users than those who did not receive an opioid prescription, according to research leader Dr. Asim Alam, of the University of Toronto, and colleagues.
Codeine was the most commonly prescribed opioid for patients who received a prescription within seven days of surgery, followed by oxycodone.
The study also found that patients who received a prescription for non-steroidal anti-inflammatory drugs (NSAIDs) within seven days of surgery were 3.7 times more likely to become long-term NSAID users than those who did not receive an early prescription.
"Our findings suggest that the prescription of codeine after short-stay surgery may contribute to the use of other potent opioids, such as oxycodone, which have been shown to be associated with increased morbidity and mortality," the researchers concluded. "These points do not even consider that the continued use of opioids after one year raises the possibility that the exposure may result in addiction or physical dependence."
The study was published March 12 in the journal Archives of Internal Medicine.
The authors of an accompanying journal commentary said previous studies have shown that opioids are more often prescribed to women than men, and that women tend to take higher doses.
They suggest that doctors discuss with their patients the risks and benefits before prescribing opioids for chronic pain.
The U.S. Food and Drug Administration offers a guide to the safe use of pain medications.
Posted: March 2012