Painkillers not as addictive as feared: study

Fewer than five percent of patients prescribed narcotics to treat chronic pain become addicted to the drugs, according to a new analysis of past research.

The finding suggests that concerns about the risk of becoming addicted to prescription painkillers might be "overblown," said addiction specialist Dr. Michael Fleming at Northwestern University's Feinberg School of Medicine.

"If you're a person that doesn't have a history of addiction and doesn't have any major psychiatric problems, narcotics are relatively safe as long as your doctor doesn't give you too much and uses the right medication," Fleming, who was not involved in the new study, told Reuters Health.

Some recent research has concluded the same thing, but another expert remained skeptical about the new report because many of the studies it included were not considered the best quality research, and they varied widely in their results.

"I think the jury's still out" on how worrisome prescription opioid addiction is, said Joseph Boscarino of the Geisinger Clinic in Danville, Pennsylvania, who studies pain and addiction.

Opioid painkillers, which include oxycodone, fentanyl and morphine, have only recently become available for patients with chronic pain, said Boscarino, who was not part of the new study.

In the past, the drugs were almost exclusively reserved for cancer patients and people with short-term pain - on the theory that in the first category of patients the need outweighed the risk, and in the second group, short term use was unlikely to lead to long-term addiction.

"They opened up (to chronic pain patients), and since then there's been a wave of addiction, especially in the last five years," Boscarino said.

One recent study found that the number of people diagnosed with a substance abuse problem increased by 70 percent from 2001 to 2009, and doctors suspect the increased popularity of prescription painkillers is a primary driver (see Reuters Health story of October 22, 2012).

Of course, not all these cases reflect patients who are using the drugs as directed - or who even have a prescription to treat chronic pain.

To get a sense of how addictive opioid painkillers are for those patients who do have a prescription, researchers from The Cochrane Collaboration, an independent group that reviews research on medications, collected the results from 17 studies covering more than 88,000 people.

All of the patients had been prescribed opioids to treat chronic pain, and nearly all of them had pain unrelated to cancer.

In 10 of the studies, patients used the painkillers for anywhere from three months to several years, while one study included just short-term use of several days and the others did not report the length of time patients were on the drugs.