Researchers find increase in illicit opioid use when patients are taken off prescription opioids


Researchers at the University of California San Francisco have found that when health care providers decrease opioid prescriptions, their patients are more likely to begin using illicit opioids.

In a study of more than 600 non-cancer pain patients in San Francisco, the research group found were not only more likely to switch to heroin if their opioid prescription was reduced or discontinued, but that they were also likely to start heroin if their dosage of opioids increased.

The study, published in the peer-reviewed journal PLOS One, surveyed patients who had been on opioid pain relievers from 2012 to 2018 both at the time of their initial prescription and after their prescription had been changed. A total of 38 participants, or 6 percent, reported using heroin or non-prescription opioids during their follow-up appointments.

The research shows that health care providers should think carefully about prescribing opioids in the first place.

“Loss of access to prescribed OPRs was associated with more frequent use of non-prescribed opioids and heroin, and increased OPR dose was associated with more frequent heroin use,” the research paper said. “In addition to being cautious with increasing OPR dose, health care providers should consider the potential unintended consequences of stopping OPR therapy when developing opioid prescribing guidelines and managing practice.”