2024-08-02 20:15:00
Nearly two-thirds of opioids prescribed to relieve patients’ pain are never used, according to a study conducted in Quebec and Ontario and published in the Journal of the Canadian Medical Association.
Study data showed that while 67% of patients took opioids on the first day, only 12% were still using them after 14 days. Half of the patients also swallowed five tablets or fewer.
That means tens of thousands of opioids are being circulated unnecessarily, with all the risks they bring.
“Before this study was published, […] No evidence to guide [les prescriptions d’opioïdes] Dr. Alexis Cournoyer, an emergency department physician at Montreal’s Sacred Heart Hospital and a clinical assistant professor at the University of Montreal’s School of Medicine, explains.
“For example, how much opioid medication do we need to provide relief to a patient in the first week or two of a fracture? So what we’ve observed is that doctors tend to prescribe more than they need, which results in a lot of medication left in patients’ pharmacies. »
Therefore, he added, the study aims to guide clinicians in minimizing unnecessary pill use.
The study’s results are based on an analysis of 2,240 patients, more than 90 per cent of whom were recruited in Quebec.
The authors found that patients prescribed opioids for renal colic or abdominal pain had a higher rate of not using opioids than patients prescribed opioids for fractures, back pain, neck pain, or other musculoskeletal problems.
“Clinicians who choose to prescribe opioids can tailor their opioid dosage to specific pain conditions based on the dosage of 5 mg morphine tablet equivalents to meet the needs of the 80% of patients described in our results,” the authors wrote.
Dr. Cournoyer said this means that 20% of patients will not experience relief and must return to the hospital again. However, he noted that it was impossible to accurately predict who would need how much benefits because of “variations” between patients with the same condition.
He then admitted that researchers were a little surprised by the proportion of opioids that were never used.
“We’re not talking about 3% or 4%,” he said. But we have to realize that basically, the purpose of a doctor’s prescription is to [des opioïdes] is to ensure patients get relief and don’t have to return to the emergency room in pain. They don’t want to do bad things. »
“better than before”
That said, Dr. Cournoyer continued, if the same study had been conducted a few years ago, these numbers might have been even more alarming, “because today, doctors are clearly aware that there is a problem with opioids. What we describe here might have Better regulations than five or ten years ago.
The study’s authors noted that pharmacists have the authority to prescribe only a portion of a patient’s prescribed pills. Clinicians can therefore add medications for this purpose to their prescriptions, with patients returning for the rest of the pills only when needed.
They also recommend adding the drug’s expected use time to prescriptions to limit the number of unused tablets in circulation. After this time, the pharmacist will not return unused portions of the tablets.
To this end, the researchers noted that in several European countries, laws limit the validity of opioid prescriptions to between five days and thirteen weeks.
We also have to figure out how to convince patients to return unused pills to pharmacies, Dr. Cournoyer said.
“That’s another question,” he concluded. People are afraid of going through painful experiences again. For people with kidney stones, the little jars in drugstores make it safer. »
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