More than half of Americans with a history of opioid use started by being prescribed high-potency opioids, which means many may have received inappropriate treatment, according to a study from a multi-institution research collaboration led by Mayo Clinic.
Researchers examined electronic health records from the OptumLabs Data Warehouse and pharmacy and medical claims data from 2007 to 2016. During that period, nearly 300,000 outpatient prescriptions were for medications reserved for people with opioid tolerance.
Researchers eliminated the prescriptions of people with certain missing demographic information, people who did not have at least six months of continuous insurance claims information at the time of the prescription, and people who recently had been hospitalized or who had an opioid poisoning diagnosis within the preceding six months.
Of the remaining 153,385 prescriptions, less than 48 percent of the patients showed evidence of prior opioid tolerance.
“Tolerance to some of the most dangerous adverse effects of opioids, including suppressing breathing and excessive sedation, develops only after a patient takes daily doses of opioids over time,” said Dr. W. Michael Hooten, a Mayo Clinic anesthesiologist and pain medicine specialist. “Patients who are not opioid-tolerant should not be receiving high-potency fentanyl or extended-release opioid products because they are susceptible to these life-threatening adverse effects.”