Men are twice as likely as women to escalate from use of opioids for chronic pain to a high dose and eventually die from drug-related causes, according to a new study from the Institute for Clinical Evaluative Sciences in Toronto.
To put it into a hard number, researcher Doctor David Juurlink says one of 27 men getting a high opioid dose will die from drug abuse, a figure he calls unconscionable. The study gains credibility because it's based on 13 years of data from Ontario's single-payer health system; it examines 285,000 people who were prescribed opioids.
A doctor, pharmacist and medical safety researcher, Juurlink says doctors are much more willing to give prescriptions for opioids and it's proving a mistake.
"For many years now, docs have been reasonably comfortable about using opioids in people with pain from cancer and pain at the end of life," Juurlink said.
"It was only in really in the mid-1990s that this huge push came to start using opioids more liberally and in a much bigger market. That's the millions of people who suffer from chronic pain that we really began to prescribe these drugs in a way that had no basis in medical evidence."
Juurlink says it's not easy to predict who will go from necessary medical use like terminal cancer to abuse and 40 percent do. Why more of them are men than women isn't clear, although he says doctors may be more willing to prescribe higher doses for men.
