Rate of addiction with narcotics is less than 1%? Perhaps not...

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Specializes in Pain Management.

I'm not sure if you've heard this statement before, but it was repeated ad naseum during many of my nursing classes: giving patients opioids rarely leads to addiction - less than 1%. This claim was usually made as a seemless introduction to a statement about how pain is the 5th vital sign, should always be treated, and nurses should have no fear about giving narcotics.

While treating pain is important, it seems that dispensing narcotics with the belief that the rate of addiction is less than 1% might not be accurate. Here is a link to the original article that numerous people have cited when repeating this claim:

http://www.uofapain.med.ualberta.ca/documents/AddictionRareinPatientstreatedwithNarcotics.pdf

Anyone find any problems with this "study"?

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Specializes in RN, Cardiac Step Down/Tele Unit.

"reasonably well documented"??? A bit vague, among other problems!

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Specializes in Pain Management.

Well, I'm not sure if this is the study that forms the basis of the previously mentioned claim, but I was steered in this direction by people familiar with the topic. If it is, then Houston, we have a problem.

This was a retrospective study of patient files from the 1970's. The authors did not state any inclusion criteria other than "...patients who received at least one narcotic..." and there is no mention of how long the patients were followed to see if addiciton developed, what the criteria was for addiction, drug history of the patients, and duration of narcotic use while inpatient...just to name a few. In addition, this looked only at the patients from one hospital in Boston - no mention of the socioeconomic, racial, gender, age, or other demographic data of the patients - yet the authors conclude that "despite widespread use of narcotic drugs in hospitals, the development of addiction is rare in medical patients with no history of addiction."

It is difficult to understand how this study has then been applied to different patient populations in different parts of the country without regard to the undefined criteria that is vital to understand the context of the study.

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Specializes in ER, ICU.

Let's see. If I have a prescription for narcs I probably won't develop a dependancy, but when purchased on the street these drugs are "highly addictive". Sure.

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Specializes in Periop, CNOR.

Probably more like 7% I would guess?

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