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Opioids work against intense pain, but the risks of side effects and dependence are high. In the United States alone, 26 people die each day from an overdose. In an international collaboration, researchers examined the prevalence of opioid prescriptions in patients with osteoarthritis in Sweden. It was found that opioids were prescribed to one in four patients between November 2014 and October 2015.
"The results show an alarming rate of opioid prescriptions for patients with osteoarthritis," said Martin Englund, professor at Lund University and physician at Skåne University Hospital, who led the In collaboration with researchers from Denmark and the United Kingdom.
The researchers based their research on the population register in southern Sweden of people aged at least 35 years old (751,579 people in total) and diagnosed with osteoarthritis of the knee or hip at one time. between 1998 and 2015 (total of 82,379 people). Using data from the Swedish Prescription Drug Registry, researchers were able to determine the number of opioid preparations prescribed to these individuals between November 1, 2014 and October 31, 2015. It would be 39, one in four patients with osteoarthritis (24%).
The study also estimated that at least 12% of all new opioid prescriptions were administered to patients with osteoarthritis. The most commonly prescribed drugs were codeine, tramadol, oxycodone and morphine.
The result is remarkable. Opioids are highly addictive preparations and are not on the list of treatments recommended for osteoarthritis in Sweden, except in extreme cases or in combination with surgical treatment. However, even when we removed all the prescriptions at the same time as the surgery, the result was very similar. "
Martin Englund, professor at Lund University
In Sweden, it is customary to collect personal data in a register related to the individual's personal identification number. Such data are not generally available in most countries.
"In general, high use or increase in the use of opioids in patients with osteoarthritis has been reported in the United States, Catalonia, Spain, and Australia. Estimating reliable numbers of opioid prescriptions preferably requires careful documentation in registers covering the entire population and all levels of health care, "says Martin Englund.
He says the results point to a major challenge in the field of osteoarthritis: there is a good basic treatment for patients – education and exercise programs for osteoarthritis – however, many patients with osteoarthritis do not use it. Subsequently, or if the improvement after the basic treatment is insufficient, there is a significant lack of quality non-surgical pharmaceutical treatment alternatives to the patient, other than symptom relief.
"If the patient has developed severe osteoarthritis and other treatments do not provide sufficient symptom relief, it is possible to suggest prosthetic surgery." a substantial and expensive surgical treatment that should only be offered to patients who really need the operation Unfortunately, the health care system lacks pharmaceutical therapeutic options capable of relieving pain and of change the course of the disease itself, that is to say to have an impact on the biological process itself.We need more research on this subject, "he said. said Martin Englund.
Source:
Journal reference:
Thorlund, J.B. et al. (2019) Use of opioids in osteoarthritis of the knee or hip: cohort study conducted in the population at the regional level. Osteoarthritis and cartilage. doi.org/10.1016/j.joca.2019.01.005.
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