As the national lens focuses sharply in on just how the pharmaceutical industry flooded the country with opioids, new research shows us just how easy it is to get hooked – even after something as run-of-the-mill as an ankle sprain.
A new report from the University of Michigan looks at how overprescribing can create new, persistent opioid users. The report — which analyzed data from a health insurance claims database for 592,000 patients — found that almost 12% of patients diagnosed with an ankle sprain filled an opioid prescription.
Then the team looked just at patients who were receiving their first opioid prescription — and found that 8.4% were still filling prescriptions three months out.
Dr. Chad Brummett, director of the Division of Pain Research at the University of Michigan Medical School, worked on the research.
"None of the recommendations for how to manage sprained ankles recommended opioids as a part of that care," he tells Here & Now‘s Robin Young.
Interview Highlights
On appropriate care for ankle sprains
“Really, the things that you do at home are appropriate. And for those that do seek care, an orthopedic surgeon or an emergency medicine physician would help you decide whether or not immobilization like a splint or a boot is a part of that care, or even crutches in some cases.”
On whether the rate of patients continuing to fill prescriptions is normal
“It’s unfortunately quite consistent with what we’ve seen in the surgical literature ... We’ve found that about 6% to 8% of people after elective surgery continue to use opioids long past what we deem normal surgical recovery. And the same thing is true in dentistry, where 80% of kids will get an opioid as a part of wisdom tooth extraction, despite the fact that we don’t recommend opioids for tooth extraction.”
On the influence of the pharmaceutical industry
“I do believe that the influence of industry-influenced prescribing among providers — and also the want among patients for those opioids. So patients coming in and saying, ‘Hey, I have a bad ankle sprain, I want an opioid. I have pain, give me a pain medication.’ And we’ve unfortunately equated pain and pain medications to opioids, when there are other non-opioid pain medications like Ibuprofen and other nonsteroidals that would be more appropriate for care of an ankle sprain.”
On whether patients are making fraudulent claims
“We certainly hear the stories and have seen the stories of patients that seek care to get opioids for feign injuries. Unfortunately, while I do believe that that is real, I also think that there are patients who don’t know better, who are just trying to get the best medical care possible, who get opioids as a part of their care. I don’t think there are hundreds of thousands of patients out there seeking opioids on a daily basis just as a way to feed an opioid-use disorder [or] opioid addiction. I think that there is a public perception issue in the U.S. where we believe that opioids are effective for all types of pain, and appropriate for all types of pain, and they’re not.”
Spandan Marasini produced this interview and edited it for broadcast with Kathleen McKenna. Francesca Paris adapted it for the web.
This article was originally published on WBUR.org.
Copyright 2020 NPR. To see more, visit https://www.npr.org. 9(MDAyMTYyMTU5MDEyOTc4NzE4ODNmYWEwYQ004))