Risk of long-term opioid use jumps after 5 days of therapy

MMWR report describes characteristics of long-term opioid users

Patients who take opioids for more than 5 days are more likely to continue taking them long-term, according to a study appearing in CDC’s March 17 Morbidity and Mortality Weekly Report.

In the study, a team of researchers analyzed the records of more than 1.2 million adults who had at least one opioid prescription between June 2006 and September 2015, including more than 33,000 who had continued opioid therapy for at least a year. They found that 6% of patients with at least 1 day of opioid therapy were still taking the medications a year later, a rate that jumped to 13.5% for those whose first episode of use lasted at least 8 days, with a spike beginning on the fifth day. That rate jumped again to 29.9% when the first episode of use lasted at least 31 days. Patients who continued opioid therapy for at least a year were more likely to be female, have a pain diagnosis before starting opioids, take long-acting opioids, and be publicly or self-insured compared with those who took opioids for less than a year. The mean age of those likely to be on opioids for more than a year was 49.58 years, compared with 44.5 years in those who discontinued therapy within a year.

In their summary, the researchers stated, “Knowledge that the risks for chronic opioid use increase with each additional day supplied might help clinicians evaluate their initial opioid prescribing decisions and potentially reduce the risk for long-term opioid use. Discussions with patients about the long-term use of opioids to manage pain should occur early in the opioid-prescribing process.”