WASHINGTON, Dec. 29 (UPI) -- A study by Wolters Kluwer Health finds that pre-existing psychiatric conditions and the use of psychoactive drugs increase a person's risk of long-term use of opioid pain medication.
Researchers used a nationwide insurance database to identify 10.3 million patients who filed insurance claims for opioid prescriptions from 2004 to 2013, examining whether pre-existing psychiatric and behavioral conditions and the use of psychoactive drugs correlated with later opioid use.
"We found that pre-existing psychiatric and behavioral conditions and psychoactive medications were associated with subsequent claims for prescription opioids," Patrick D. Quinn, Ph.D., of Indiana University and study author, said in a press release.
The link was stronger for long-term opioid use in patients with a previous history of substance use disorders. The results showed that harmful outcomes of opioid use -- substance use disorders, depression, suicidal or self-injuring behavior and motor vehicle accidents -- were predictors for long-term opioid drug use.
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The study found that about 1.7 percent of patients with opioid prescriptions became long-term opioid users; however, the risk was substantially higher for patients with mental health conditions or who used psychoactive medications.
Rates of increase of long-term opioid use ranged from 1.5 times for patients with attention-deficit/hyperactivity disorder, or ADHD, three times for previous substance use disorders and nine times for previous opioid use disorders.
"Our results add to existing evidence that the risk of long-term opioid receipt associated with pre-existing psychiatric and behavioral conditions is widespread and relates to multiple diagnoses and psychoactive medications," Quinn said. "Our findings support the ideas that clinical practice has deviated from the 'careful selection' under which most clinical trials are conducted and that thorough mental health assessment and intervention should be considered in conjunction with the use of long-term opioid therapy."
The study was published in PAIN.
