Among opioid-naive patients receiving opioids, more intensive opioid prescribing in the first month is associated with transition to long-term opioid use

Commentary on:  Deyo RA, Hallvik SE, Hildebran C, et al . Association between initial opioid prescribing patterns and subsequent long-term use among opioid-naive patients: a statewide retrospective cohort study. J Gen Intern Med 2017;32(1):21-7. A recent systematic review of long-term opioid use for chronic pain found that evidence is lacking to support benefit from long-term opioid therapy, and evidence supports a dose-dependent risk of opioid-related harms including overdose and death.1 Despite the evidence, an estimated 5 to 8 million Americans receive long-term opioid therapy.2 Understanding the transition from acute or episodic use of opioids to long-term opioid use may help design interventions to reduce the incidence of long-term opioid use. This study sought to analyse the association between prescribing patterns in the first 30 days of opioid receipt among formerly opioid-naive subjects and transitioning to long-term opioid use. …