Can We Predict Who Will Misuse Opioids?

July 25, 2019

Written by Clay Smith

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Current or past substance abuse, mental health diagnosis, age <40 years, and male sex increased risk of subsequent opiate misuse after an initial opiate prescription.

Why does this matter?
Opiate abuse is rampant. Wouldn’t it be nice if we could predict which patients would subsequently abuse opiates after an initial prescription? Maybe this study can help.

New risk factor for opiate abuse – maleness
This was a meta-analysis of 65 studies. They found the risk of subsequent opiate misuse was greatest in patients with current or previous substance use (OR 3.6), mental health diagnosis (OR 2.5), age <40 years (OR 2.2), and male sex (OR 1.2). More and more we are using opiate alternatives for pain. This list of four risk factors should be considered as even higher priority for use of opiate alternatives.

Source
Risk Factors for Misuse of Prescribed Opioids: A Systematic Review and Meta-Analysis. Ann Emerg Med. 2019 Jun 19. pii: S0196-0644(19)30342-7. doi: 10.1016/j.annemergmed.2019.04.019. [Epub ahead of print]

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Reviewed by Thomas Davis