Patients who overdose on opioids get them again, study shows

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BOSTON – Most patients who receive drugs to treat chronic pain and overdose on opioid medications still get the addictive synthetic opiates through their doctors, a new study shows.

The 12-year study released Monday by the Boston Medical Center tracked almost 3,000 people who were treated in an emergency room or hospitalized for overdosing on prescription opioid painkillers. Researchers led by Dr. Marc LaRochelle, a BMC doctor, found that 91 percent of patients who had overdosed still received prescriptions for the same drugs, including 70 percent who got them from the same doctor. Those who continued to use the painkillers after overdosing were twice as likely to overdose again, the research showed.

“It is unclear if the physician who prescribed the medication was notified when their patient experienced an overdose event, which is important to note,” LaRochelle said in a statement about the study. “As a provider, this is troublesome because this is information that I need access to in order to best treat my patient.”

More than 1,200 drug users died from opioid overdoses – including heroin – last year in Massachusetts alone, according to state figures. Physicians have been challenged to balance drug risks with benefits for chronic-pain patients when it comes to prescribing synthetic opiates, which can lead to heroin abuse. Potential solutions include better communication between hospitals, doctors and prescription-drug monitoring programs, according to the BMC statement.

The study, which was partly funded by the federal Health Resources and Services Administration, was published in the Annals of Internal Medicine.

An epidemic of opioid abuse and related deaths has gripped much of the nation since at least last year. Massachusetts Gov. Charlie Baker made it a focus of his administration’s first year, and proposed measures to deal with addiction, including letting doctors hold patients for as long as three days in involuntary confinement if they are deemed to be a threat to themselves.

On Monday, state lawmakers pushed forward a less-stringent proposal that would not let doctors hold patients involuntarily. The measure from Democrats in the House of Representatives also would curb another major provision of Baker’s measure by limiting new opioid prescriptions to a seven-day supply; Baker had sought a three-day cap. The House bill also would let doctors require substance abuse tests for anyone admitted to an emergency room because of an overdose.

Legislative responses to the epidemic partly reflect rising public concern and awareness of the issue. On Monday evening, the Home Box Office, or HBO, cable network broadcast “Heroin: Cape Cod, USA,” a documentary exploring addiction in the Bay State vacation hot spot.

Contact Kara Bettis at [email protected] or on Twitter @karabettis.