Adults who began treatment for a new bout of low back pain with a higher-dose opioid prescription were about two and a half times as likely to later show signs of opioid use disorder or overdose, according to a Medicaid study in JAMA Network Open published Oct. 19. The researchers calculated a 146.6% higher relative risk for patients whose first-month treatment included opioids above 50 milligrams of morphine equivalent per day.
The absolute numbers are much smaller than that percentage suggests. Among patients followed for 13 months, about 2.3% had a new opioid use disorder diagnosis, a nonfatal overdose, or a prescription for an addiction treatment drug such as buprenorphine or methadone. A relative increase sits on top of a small starting risk, so it does not mean most people given a stronger painkiller developed a problem.
