Open Access Open Access  Restricted Access Subscription or Fee Access

Iatrogenic addiction or dependence as a result of prescription oxycodone use in persons with chronic noncancer pain: A systematic review

Megan Dol, BSc, Mark Oremus, PhD

Abstract


Objective: To determine the incidence of addiction and dependence in persons with chronic noncancer pain (CNCP) who are treated with oxycodone.

Design: Systematic review following PRISMA guidelines.

Methods: PubMed, MEDLINE, EMBASE, CINAHL, PsycINFO, and Cochrane Library were searched from inception to January 2020. Of 1,320 retrieved citations screened by two independent raters at title and abstract and full-text screening, six articles fulfilled the eligibility criteria for the systematic review. Data extraction and risk of bias assessment followed article screening. The Cochrane Collaboration tool and the Newcastle-Ottawa Scale (NOS) were used to assess the risk of bias in individual studies.

Results: Two of the six articles reported addiction and the remaining four reported dependence. The incidence rates of addiction were 2.91 percent and 1.72 percent, and the incidence rates of dependence were 0.00 percent, 0.44 percent, 0.45 percent, and 5.77 percent. In all articles, addiction and dependence were treated as secondary outcomes. Three randomized controlled trials (RCTs) had follow-up lengths of less than 31 days, which is insufficient to assess the incidence of addiction or dependence.

Conclusions: The results of this systematic review show that oxycodone use leads to addiction and dependence in a small proportion of individuals with CNCP. However, one must exercise caution when drawing conclusions from the six included articles. Future studies in the area should examine addiction and dependence as primary outcomes using adequate follow-up periods.


Keywords


chronic noncancer pain, oxycodone, addiction, opioid use disorder, dependence, opioid withdrawal syndrome

Full Text:

PDF

References


Evans CJ, Cahill CM: Neurobiology of opioid dependence in creating addiction vulnerability. F1000Res. 2016; 5: 1748.

Manchikanti L, Kaye AM, Knezevic NN, et al.: Responsible, safe, and effective prescription of opioids for chronic non-cancer pain: American Society of Interventional Pain Physicians (ASIPP) guidelines. Pain Phys. 2017; 20(2S): S3-S92.

Pitt AL, Humphreys K, Brandeau ML: Modeling health benefits and harms of public policy responses to the US opioid epidemic. Am J Public Health. 2018; 108(10): 1394-1400.

Burden M, Keniston A, Wallace MA, et al.: Opioid utilization and perception of pain control in hospitalized patients: A cross-sectional study of 11 sites in 8 countries. J Hosp Med. 2019; 14: E1-E9.

Kenan K, Mack K, Paulozzi L: Trends in prescriptions for oxycodone and other commonly used opioids in the United States, 2000–2010. Open Med. 2012; 6(2): e41.

Manchikanti L, Fellows B, Ailinani H: Therapeutic use, abuse, and nonmedical use of opioids: A ten-year perspective. Pain Phys. 2010; 13: 401-435.

Centers for Disease Control and Prevention: Prescribing practices. CDC: 2019. [Online]. Available at https://www.cdc.gov/drugoverdose/data/prescribing/prescribing-practices.html. Accessed October 6, 2019.

Minhas M, Leri F: A multifaceted analysis of oxycodone addiction. Int J Ment Health Addict. 2018; 16(4): 1016-1032.

Comer SD, Metz VE, Cooper ZD, et al.: Comparison of a drug versus money and drug versus drug self-administration choice procedure with oxycodone and morphine in opioid addicts. Behav Pharmacol. 2013; 24(0): 504-516.

Centers for Disease Control and Prevention: Overdose death maps. CDC: 2019. [Online]. Available at https://www.cdc.gov/drugoverdose/data/prescribing/overdose-death-maps.html. Accessed October 6, 2019.

Van Z: The promotion and marketing of oxycontin: Commercial triumph, public health tragedy. Am J Public Health. 2009; 99(2): 221-227.

Daubresse M, Chang HY, Yu Y, et al.: Ambulatory diagnosis and treatment of non-malignant pain in the United States, 2000–2010. Med Care. 2013; 51(10): 870-878.

Sehgal N, Manchikanti L, Smith HS: Prescription opioid abuse in chronic pain: A review of opioid abuse predictors and strategies to curb opioid abuse. Pain Phys. 2012; 15(3 Suppl): ES67-ES92.

Edlund MJ, Martin BC, Russo JE, et al.: The role of opioid prescription in incident opioid abuse and dependence among individuals with chronic non-cancer pain: The role of opioid prescription. Clin J Pain. 2014; 30(7): 557-564.

Juurlink DN, Dhalla IA: Dependence and addiction during chronic opioid therapy. J Med Toxicol. 2012; 8(4): 393-399.

Soyka M: Treatment of opioid dependence with buprenorphine: current update. Dialogues Clin Neurosci. 2017; 19(3): 299-308.

Kolodny A, Courtwright DT, Hwang CS, et al.: The prescription opioid and heroin crisis: A public health approach to an epidemic of addiction. Annu Rev Public Health. 2015; 36: 559-574.

Lin HC, Wang Z, Boyd C, et al.: Associations between statewide prescription drug monitoring program (PDMP) requirement and physician patterns of prescribing opioid analgesics for patients with non-cancer chronic pain. Addict Behav. 2018; 76: 348-354.

Cooper TE, Fisher E, Gray A, et al.: Opioids for chronic noncancer pain in children and adolescents. Cochrane Database of Syst Rev. 2017; 7.

Volkow ND, Morales M: The brain on drugs: From reward to addiction. Cell. 2015; 162(4): 712-725. 21. Vander Weele CM, Porter-Stransky KA, Mabrouk OS, et al.: Rapid dopamine transmission within the nucleus accumbens: Dramatic difference between morphine and oxycodone delivery. Eur J Neurosci. 2014; 40(7): 3041-3054.

Olczak B, Kowalski G, Leppert W, et al.: Analgesic efficacy, adverse effects, and safety of oxycodone administered as continuous intravenous infusion in patients after total hip arthroplasty. J Pain Res. 2017; 10: 1027.

Ding Z, Wang K, Wang B, et al.: Efficacy and tolerability of oxycodone versus fentanyl for intravenous patient-controlled analgesia after gastrointestinal laparotomy: a prospective, randomized, double-blind study. Medicine. 2016; 95(39): e4943.

Kinnunen M, Piirainen P, Kokki H, et al.: Updated clinical pharmacokinetics and pharmacodynamics of oxycodone. Clin Pharmacokinet. 2019; 58(6): 705-725.

Ruan X, Mancuso KF, Kaye AD: Revisiting oxycodone analgesia: A review and hypothesis. Anesthesiol Clin. 2017; 35(2): e163-e174.

Dhalla IA, Mamdani MM, Sivilotti ML, et al.: Prescribing of opioid analgesics and related mortality before and after the introduction of long-acting oxycodone. CMAJ. 2009; 181(12): 891-896.

Nelson LS, Juurlink DN, Perrone J: Addressing the opioid epidemic. JAMA. 2015; 314(14): 1453-1454.

Volkow ND, McLellan AT: Opioid abuse in chronic pain—misconceptions and mitigation strategies. N Engl J Med. 2016; 374(13): 1253-1263.

Liberati A, Altman DG, Tetzlaff J, et al.: The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate healthcare interventions: explanation and elaboration. BMJ. 2009; 339: b2700.

Ferreira-Valente MA, Pais-Ribeiro JL, Jensen MP: Validity of four pain intensity rating scales. Pain. 2011; 152(10): 2399-2404.

Hjermstad MJ, Fayers PM, Haugen DF, et al.: Studies comparing numerical rating scales, verbal rating scales, and visual analogue scales for assessment of pain intensity in adults: a systematic literature review. J Pain Symptom Manage. 2011; 41(6): 1073-1093.

Rosas S, Paco M, Lemos C, et al.: Comparison between the visual analog scale and the numerical rating scale in the perception of esthetics and pain. Int Orthod. 2017; 15(4): 543-560.

Ware LJ, Herr KA, Booker SS, et al.: Psychometric evaluation of the revised Iowa pain thermometer (IPT-R) in a sample of diverse cognitively intact and impaired older adults: A pilot study. Pain Manag Nurs. 2015; 16(4): 475-482.

Jamison RN, Martel MO, Edwards RR, et al.: Validation of a brief opioid compliance checklist for patients with chronic pain. J Pain. 2014; 15(11): 1092-1101.

Barbosa-Leiker C, McPherson S, Mamey MR, et al.: Examining the factor structure of the clinical opiate withdrawal scale: A secondary data analysis from the National Drug Abuse

Treatment Clinical Trials Network (CTN) 0003. Drug Alcohol Depend. 2015; 152: 218-223.

Webster LR, Nalamachu S, Morlion B, et al.: Long-term use of naldemedine in the treatment of opioid-induced constipation in patients with chronic noncancer pain: A randomized, double-blind, placebo-controlled.

Higgins JP, Green S: Cochrane handbook for systematic reviews of interventions version 5.1. 0. The Cochrane Collaboration; 2011. Available at https://handbook-5-1.cochrane.org/front_page.htm. Accessed November 18, 2018.

Higgins JP, Altman DG, Gøtzsche PC, et al.: The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ. 2011; 343: d5928.

Wells GA, Shea B, O’Connell D, et al.: The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analyses. Ottawa Hospital Research Institute 2011. Available at http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp. Accessed November 18, 2018.

Margulis AV, Pladevall M, Riera-Guardia N, et al.: Quality assessment of observational studies in a drug-safety systematic review, comparison of two tools: The Newcastle–Ottawa scale and the RTI item bank. Clin Epidemiol. 2014; 6: 359-368.

Campbell M, Katikireddi SV, Sowden A, et al.: Lack of transparency in reporting narrative synthesis of quantitative data: A methodological assessment of systematic reviews. J Clin Epidemiol. 2018; 105: 1-9.

Kawamata M, Iseki M, Kawakami M, et al.: Efficacy and safety of controlled-release oxycodone for the management of moderate-to-severe chronic low back pain in Japan: Results of an enriched enrollment randomized withdrawal study followed by an open-label extension study. J Pain Res. 2019; 12: 363.

Richarz U, Waechter S, Sabatowski R, et al.: Sustained safety and efficacy of once-daily hydromorphone extended-release (OROS® hydromorphone ER) compared with twice-daily oxycodone controlled-release over 52 weeks in patients with moderate to severe chronic noncancer pain. Pain Pract. 2013; 13(1): 30-40.

Wild JE, Grond S, Kuperwasser B, et al.: Long-term safety and tolerability of tapentadol extended release for the management of chronic low back pain or osteoarthritis pain. Pain Pract. 2010; 10(5): 416-427.

Ytterberg SR, Mahowald ML, Woods SR: Codeine and oxycodone use in patients with chronic rheumatic disease pain. Arthritis Rheum. 1998; 41(9): 1603-1612.

Portenoy RK, Farrar JT, Backonja MM, et al.: Long-term use of controlled-release oxycodone for noncancer pain: Results of a 3-year registry study. Clin J Pain. 2007; 23(4): 287-299.

Osmun WE, Copeland K, Parr J, et al.: Characteristics of chronic pain patients in a rural teaching practice. Can Fam Phys. 2011; 57(11): e436-e440.

National Institute on Drug Abuse: Opioid overdose crisis. NIDA; 2018. Available at https://www.drugabuse.gov/drugsabuse/opioids/opioid-overdose-crisis#eight. Accessed December 21 2019.

Minozzi S, Amato L, Davoli M: Development of dependence following treatment with opioid analgesics for pain relief: A systematic review. Addiction. 2013; 108(4): 688-698.

Dugosh K, Abraham A, Seymour B, et al.: A systematic review on the use of psychosocial interventions in conjunction with medications for the treatment of opioid addiction. J Addict Med. 2016; 10(2): 93-103.

Fishbain DA, Cole B, Lewis J, et al.: What percentage of chronic nonmalignant pain patients exposed to chronic opioid analgesic therapy develop abuse/addiction and/or aberrant drug-related behaviors? A structured evidence-based review. Pain Med. 2007; 9(4): 444-459.

Busse J: The 2017 Canadian guideline for opioids for chronic non-cancer pain. Hamilton, Ontario, Canada: McMaster University; 2017. Available at http://cpspei.ca/wp-content/uploads/2012/01/Guideline-for-Opioids-for-Chronic-Non-Cancer-Pain-McMaster-May-2017-Approved-by-Council-June-19-2017.pdf. Accessed December 21 2019.

Voon P, Karamouzian M, Kerr T: Chronic pain and opioid misuse: A review of reviews. Subst Abuse Treat Prev Policy. 2017; 12(1): 36.

Anthon CT, Granholm A, Perner A, et al.: The effect of blinding on estimates of mortality in randomized clinical trials of intensive care interventions: Protocol for a systematic review and meta-analysis. BMJ Open. 2017; 7(7): e016187.

Busse JW, Schandelmaier S, Kamaleldin M, et al.: Opioids for chronic non-cancer pain: A protocol for a systematic review of randomized controlled trials. Syst Rev. 2013; 2(1): 66.

ICSI: Pain; assessment, non-opioid treatment approaches and opioid management. Available at https://www.icsi.org/guideline/pain/. Accessed December 21, 2019.

Garofoli M: What types of risk screening tests are available to clinicians prescribing opioid therapy? Practical Pain Management. Available at https://www.practicalpainmanagement.com/resources/diagnostic-tests/what-types-risk-screeningtests-are-available-clinicians-prescribing. Accessed December 21, 2019.

Dowell D, Haegerich TM, Chou R: CDC guideline for prescribing opioids for chronic pain—United States, 2016. JAMA. 2016; 315(15): 1624-1645.

Noble M, Tregear SJ, Treadwell JR, et al.: Long-term opioid therapy for chronic noncancer pain: a systematic review and meta-analysis of efficacy and safety. J Pain Symptom Manage. 2008; 35(2): 214-228.

Rudd RA: Increases in drug and opioid-involved overdose deaths—United States, 2010–2015. MMWR Morb Mortal Wkly Rep. 2016; 65: 1445-1452.




DOI: https://doi.org/10.5055/jom.2021.0616

Refbacks

  • There are currently no refbacks.