Trends in long-term opioid prescribing in primary care patients with musculoskeletal conditions: an observational database study

Abstract

Supplemental Digital Content is Available in the Text.Long-term opioid use decreased from 2011, but the proportion of more potent opioids prescribed increased. Ongoing review of effectiveness and need for discontinuation is important.

What proportion of patients with chronic noncancer pain are prescribed an opioid medicine? Systematic review and meta‐regression of observational studies

“…Global opioid prescribing doubled between 2001–03 and 2011–13 . Several developed countries have noted substantial increases in opioid prescriptions including the United States of America (USA) , Canada , the United Kingdom (UK) , Scotland and Australia , and also for some strong prescription opioids such as oxycodone .…”

“…Opioid analgesics are often used to manage chronic noncancer pain . Previously, opioids were considered an appropriate strategy to manage chronic noncancer pain.…”

National trends in long‐term use of prescription opioids

“…Over the past 2 decades, prescription of opioids has increased dramatically in the USA and less so in other countries . In a study based on a national surveys of office‐based physicians, the visits that included an opioid prescription increased from 0.65% in 1995‐1998 to 2.63% in 2007‐2010 .…”

“…Over the past 2 decades, prescription of opioids has increased dramatically in the USA and less so in other countries. [1][2][3][4][5][6][7][8] In a study based on a national surveys of office-based physicians, the visits that included an opioid prescription increased from 0.65% in 1995-1998 to 2.63% in 2007-2010. 5 This increase has been associated with concurrent increases in misuse of these medications, increased morbidity, and higher rates of mortality due to opioid overdose.…”

Comparative out‐of‐hospital mortality of long‐acting opioids prescribed for non‐cancer pain: A retrospective cohort study

“…8,9 Despite these trends, prescriptions for long-acting opioids treating chronic non-cancer pain have continued to increase over the past two decades. 10,11 Amidst larger concerns about opioid safety, scholars, and government institutions have issued alerts and recommendations regarding two opioids with specific administration-transdermal fentanyl and oxycodone CR-indicating that these drugs may pose greater risks for toxicity compared with more established long-acting opioids, such as morphine SR, 7,12 the preferred long-acting opioid for severe pain by US practitioners 13 and a prototypical mu opioid agonist. 14 Risks for overdose among transdermal fentanyl users most plausibly are related to its route of administration and pharmacodynamics, which produce significant inter-individual variability.…”