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Addiction Rare in Chronic Pain Patients


Almost everyone who takes prescription opioids for an extended period will become physically dependent, however only a SMALL PERCENTAGE also experience the compulsive, continuing need or ‘craving’ to get high that characterises psychological addiction.

Responsible chronic pain patients, using their legally prescribed opioids as directed, did not cause any “opioid crisis” in America or Australia, yet we are always needlessly & relentlessly targeted whenever prescription opioids are mentioned in the mainstream media or online.

I’ve posted many of these reputable Articles on Facebook & LinkedIn before, all of which clearly indicate where there is “No previous history of Opioid Use Disorder [OUD]”, the addiction rate in chronic pain patients is Always less than 1%. Please share or show these Articles to educate anyone who believes otherwise:


EXCERPT: “For the abuse/addiction grouping there were 24 studies with 2,507 CPPs exposed for a calculated abuse/addiction rate of 3.27%. Within this grouping for those studies that had preselected CPPs for COAT – CHRONIC OPIOID ANALGESIC TREATMENT – exposure for no previous or current history of abuse/addiction, the percentage of abuse/addiction was calculated at 0.19%“

ARTICLE 2 [FURTHER REFERENCE TO “0.19%” STATISTIC].…/the-truth-about…

EXCERPT: “Another representative study, this one from a research team at Harvard University in 2018, discerned signs of opioid abuse and addiction in only 0.6% of over half a million privately insured patients prescribed opioids for post-surgical or acute pain. And in a 2016 Washington University survey of almost 700,000 patients, 0.3% abused or developed an addiction to opioids within a year after receiving at least one prescription.

Even among patients undergoing treatment for chronic pain, only a small percentage are at risk of abusing or developing an addiction to opioids. A team led by a scholar at the Research Triangle Institute, for instance, found that 0.12% to 6.1% of half a million chronic-pain patients abused or developed an addiction to opioids within 18 months of starting treatment. The Cochrane Library, a respected independent collection of databases, found that in a combined sample of 2,600 patients drawn from nine separate studies, only 0.27% developed signs of opioid addiction.Another review, co-authored by the director of the National Institute on Drug Abuse and published in the New England Journal of Medicine, found “rates of carefully diagnosed addiction [averaging] less than 8 percent” in chronic-pain patients.

Why do estimates of opiate abuse and addiction range from under 1% to 8% of these patients? Researchers from the University of Miami shed valuable light on the question when, in a review of 24 studies on patients prescribed opioids, they distinguished between patients experiencing pain with a history of substance abuse or addiction and those without. They found that an average rate of new-onset drug abuse or addiction for pain patients overall was 3.27%. But when they examined the four studies that had deliberately excluded patients with a history of substance abuse or addiction, the rates shrivelled to 0.19%.”



EXCERPT 1: ”Pain patients very rarely become addicted.

An addict is a person who compulsively takes drugs for nonmedicinal purposes. Addicts will continue to seek out the drugs despite bad effects on their ability to function in the community, to hold a job, to care for their families and to maintain social relationships.

In contrast, pain patients often take very large amounts of opioids and other medications to improve their function, but do not seek out the drug for its own sake or “crave” the medication. Their ability to work, care for families and live productive lives is improved by their medications.”

A recent study demonstrates that fewer than one percent of pain patients receiving opioids become narcotics abusers. No patient in pain should hear that relief is barred because “you will become an addict.” No patient in pain should reject opioids out of fear of becoming addicted. Even former and current substance abusers can be treated for severe pain by doctors with experience in the field.”

EXCERPT 2: “Perhaps the most prominent narrative about the crisis indiscriminately points to all prescription-opioid use as the driving cause of addictions, overdoses, and fatalities. The media (and, recently…have magnified this idea with bold and overly simplistic claims suggesting a direct and inevitable link between opioid prescriptions and addictions—even heroin use. But this narrative is flawed, as illustrated by the most recent data from the Substance Abuse and Mental Health Services Administration. Of the nearly 92 million people who used prescription opioids in 2016, fewer than 1.8 million (less than 2%) developed or maintained a prescription-opioid use disorder. And only 641,000 people who misused prescription opioids used heroin, meaning that less than 1% of prescription-opioid users—including those who obtained them illegally or otherwise misused them—used heroin in 2016.Furthermore, prescription-opioid misuse is largely confounded with other drug and alcohol use, which is inextricably linked to the high overdose count. Ultimately, the opioid crisis is more complex than often suggested.”


EXCERPT: “Highlighting an undisputable fact that patients on opioids for analgesia don’t experience a “high”, just simply pain relief; & that patients requiring prescribed opioids for pain have zero to do with drug addicts who “choose” illicit substances to get “high”. Further making the point and well established fact that less than 1% of drug abuse or addiction is via prescription narcotics and that NO ONE overdoses from taking prescription opiates as prescribed.”


EXCERPT: “Addiction is a recognised disease process, which is particularly exacerbated in a small percentage of people by genetic predisposition, NOT something that use of opioid medications will cause in 100% of people prescribed appropriately. It is statistically true that addiction rates in the general population have not changed for over a hundred years, despite many prohibitionist Government’s claims to the contrary: the 800,000 addicts in the U.S. or less than 1% is exactly the same as in 1920.”

ARTICLE 6…/the-myth-of-the-roots-of…/

EXCERPT: “For example, it is true that among people who are prescribed opioids, addiction is relatively uncommon. According to an article by renowned addiction psychologist Dr. Sally Satel, who talks about the myth of what drives the opioid crisis: the percentage of patients who become addicted after taking opioids for chronic pain is measured in the single digits; studies show an incidence from LESS THAN 1 percent to 8 percent.”

ARTICLE 7…/article/0,8599,1964782,00.html

EXCERPT: “In a review published in the Jan. 20 issue of the Cochrane Database of Systematic Reviews, a leading evidence-based-medicine journal, researchers found that only one-third of 1% of chronic-pain patients without a history of substance problems became addicted to opioids during treatment.”


Are Prescription Opioids Driving the Opioid Crisis? Assumptions vs Facts.

EXCERPT: “A Cochrane Review evaluated 26 prospective opioid trials in subjects with chronic pain (opioid therapy for six or more months) with prior nonopioid analgesic failure. In studies specifically reporting abuse or addiction rates, seven patients (0.27%) developed opioid use disorder (OUD) of their prescribed opioid.”


ARTICLE 9…/opioid-epidemic-6-charts…

EXCERPT: “It can reasonably be assumed that the number of deaths from opioid pills alone will be much lower, perhaps in the neighbourhood of 5,000—ten-times lower the 60,000 that Kolodny implies. This is what the hysteria is about?”

ARTICLE 10 [Part 1]

EXCERPT: “We are absolutely doing the opposite of solving the opioid crisis by continuing to limit prescribing by doctors. Even worse, the cutback in prescribing is causing pain patients and the physicians who care for them irreparable harm.”

ARTICLE 10 [Part 2]…/

EXCERPT: “The ones most impacted by these efforts are not the illegal drug suppliers. It’s the patients with intractable pain and undiagnosed mental health problems who are suffering, along with the dedicated professionals trying to care for them.”

ARTICLE 11…/what-are-the-long…

Initial opioid prescription patterns and the risk of ongoing use and adverse outcomes.

EXCERPT: “In a recent Canadian study, researchers looked at over 2 million individuals in Ontario given an opioid prescription between 2013 and 2016 for pain. They identified 1,121 patients who had a fatal or non-fatal overdose – a minuscule overdose rate of 0.0055 percent.”


Opioid-related overdose and chronic use following an initial prescription of hydrocodone versus oxycodone.

EXCERPT: “In a retrospective analysis of patients in Oregon between 2015 and 2017, researchers found that after an initial prescription in opioid-naive people, 0.3% experienced a fatal or non-fatal overdose and 2.8% refilled an opioid prescription at least six times, what the researchers considered “chronic opioid use.”

ARTICLE 13…/article/17/1/85/1752837…

Study of the Impact of High-Dose Opioid Analgesics on Overdose Mortality

EXCERPT: ”Of 2,182,374 patients prescribed opioids, 478 overdose deaths were reported (0.022% per year).”

Kevin R James

Table of Contents

Author: Kevin R James

Chronic Pan Patient Advocate and Writer. Medically Retired RN [B.Nurs.]


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