Study on Prescription Opioids in Michigan

Overview of the Research

A recent study conducted in Michigan examined the correlation between the quantity of prescription opioids prescribed by doctors and the actual number of pills consumed by patients. Over a nine-month duration, tens of thousands of leftover prescription opioid pills circulated within communities across the state. Previous research has indicated that most individuals who misuse prescription opioids obtain these medications from friends or relatives, and many addicts first encounter opioids through prescriptions.

Objective of the Study

Given the role of excessive opioid prescribing in the ongoing opioid crisis, the researchers aimed to determine how many pills prescribed are utilized by patients and what factors influence whether a patient completes their prescription. The findings of this study were published in JAMA Surgery.

Research Methodology

The study utilized a state-wide database that included information about patients who underwent specific surgical procedures and received opioid prescriptions for post-operative pain management. Data from over 2,000 patients, including their general health and prescription sizes, were analyzed. This information was then contrasted with survey responses from patients regarding the number of pills they actually consumed after surgery.

Key Findings

Researchers discovered that patients with larger quantities of prescribed opioids were more likely to consume greater amounts. Notably, this increase in consumption did not correlate with higher levels of pain; rather, it suggested that patients took more opioids simply because they had more available. This phenomenon mirrors the scientifically-supported observation that individuals provided with larger food portions tend to eat more, not necessarily due to increased hunger. Additionally, factors such as tobacco use, younger age, and poor overall health were linked to a higher likelihood of increased medication use.

Conclusions and Recommendations

The researchers arrived at two primary conclusions. Firstly, they determined that doctors tend to over-prescribe opioids, with only 25% of the prescribed medications actually being consumed. Secondly, they identified specific patient characteristics that could lead to increased usage of prescribed opioids.

To address these issues, the researchers recommend that physicians personalize opioid prescriptions based on individual patient profiles. For instance, an 80-year-old non-smoker may require less post-operative pain relief than a 30-year-old smoker in poor health. Implementing more tailored prescribing practices could help decrease the number of opioid pills circulating in the community, thereby mitigating the impact of the opioid crisis.

References

Howard R, Gunaseelan V, Lee J, et al. Association of Opioid Prescribing With Opioid Consumption After Surgery in Michigan. JAMA Surg. 2018. doi:10.1001/jamasurg.2018.4234
Hartford L, Koughnett J, Murphy P, et al. Standardization of Outpatient Procedure (STOP) Narcotics: A Prospective Non-Inferiority Study to Reduce Opioid Use in Outpatient General Surgical Procedures. J Am Coll Surgeons. 2018. doi:10.1016/j.jamcollsurg.2018.09.008.