Higher Dosages And Fewer Refills May Curb Addiction, Study Suggests

By Beth Leipholtz 01/30/18

Could providing more pain relief over a shorter timeframe be the key?

person pouring pills into hand

It would seem that in order to cut down on opioid overdoses and deaths, the answer would be to prescribe fewer drugs, not more. 

But a new BMJ study suggests the opposite, stating that it may prove effective to provide higher doses of powerful painkillers to patients, with fewer refills.

The idea is that by giving high doses, patients would be given more pain relief early on, which would in turn allow them to stop taking painkillers sooner. The study suggests that being on the medications for a shorter amount of time would result in patients being less likely to develop addiction or abuse. 

"The data from this study suggest that duration of the prescription rather than dosage is more strongly associated with ultimate misuse in the early postsurgical period," the study stated. 

More specifically, the research states that for patients on medications such as oxycodone and hydrocodone, every additional week of taking the medication increases the chance of abuse by 20%. And for every time an opioid painkiller prescription is refilled, the chance of abuse increases by 44%. 

The results of the study were based on data collected from millions of Americans with health and pharmacy insurance through insurer Aetna. Each patient in the study had some form of surgery between 2008 and 2016, with 56% filling a prescription for an opioid pain medication after the surgery. 

Over the course of the study, the number of patients described as dependent on the drugs, abusing the drugs or overdosing on the drugs grew. In 2009, researchers stated there were 183 cases of misuse for every 100,000 people. By the end of the study, that number increased to 269 cases per 100,000 people.

It was noted that over the years of the study, doctors prescribed lower doses of opioids and spread them over a longer timeframe. 

According to researchers, the outcomes of this study are important for a number of reasons. 

“Our findings are important as they offer a potential lever for intervention and behavior change after surgery,” wrote the researchers. “Given that surgical and non-surgical patients receive similar numbers of opioid refills, these findings have the potential to extend beyond surgery.”

Researchers also stated that although surgeons and non-surgeons are changing their opioid prescriptions, the rate of misuse is still increasing. This, they say, requires further study in the future. 

“With these seemingly conflicting forces at play, our analysis provides a broad evidentiary framework to inform clinician behavior and promote protocol development,” the study concluded. “Further research of this relation is needed to determine how initial treatment regimens can minimize misuse and addiction.”

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Beth is a Minnesota girl who got sober at age 20. By day she is a website designer, and in her spare time she enjoys writing about recovery at www.lifetobecontinued.com, doing graphic design and spending time with her boyfriend and three dogs. Find Beth on LinkedInInstagram and Twitter.