The risk of a single 5-day opioid prescription, in one chart
Now that it’s clear opioid painkillers have helped cause the worst drug epidemic in history, health experts are scrambling to figure out when dependency on these powerful prescription drugs starts — and how to prevent it.
A new study from the Centers for Disease Control and Prevention looked at the relationship between the number of days of someone’s first opioid prescription and their long-term use. It found that that number has a huge impact: Patients face an increased risk of opioid dependency in as few as four days of taking the drugs.
As you can see in the chart below, opioid prescriptions longer than five days in length significantly increased the likelihood of continued opioid use both one and three years later.
“There’s nothing magical about five days versus six days, but with each day your risk of dependency increases fairly dramatically,” said Bradley Martin of the CDC, one of the study authors.
The study, which analyzed 1.3 million non-cancer patients, also found that only 6 percent of patients prescribed a one-day supply of opioids were still taking the drugs a year later, but that number doubled to 12 percent if patients were prescribed a six-day supply and quadrupled to 24 percent if patients were given a 12-day supply.
Some in the medical community have pushed back against CDC guidelines released last spring that advise initial opioid prescriptions be limited to seven days or less, arguing that short prescriptions puts patients at risk of “inhumane treatment.”
According to Martin, this argument doesn’t hold up well since, for one, we don’t have good data on the effectiveness of opioids to treat long-term pain.
What’s more, Martin is concerned that doctors still don’t appreciate just how quickly people can get hooked on these drugs. “[For people who] take an opioid for 10 days, almost one in five will still be taking opioids one year later,” said Martin.
To be clear, the researchers are not equating long-term opioid use with addiction in their study. But given that opioid addiction rates and overdose deaths are high, they’re hoping physicians will make more careful opioid prescribing decisions to reduce the risk of patients developing long-term issues with the drugs.