The risk of death is dramatically higher for people with opioid addictions, but researchers have found that some simple measures may reduce that risk.
A new study from the RAND Corporation concluded that following three aspects of care led to a decrease in mortality by one-third.
The trio of treatments include quarterly physician visits, psychosocial counseling, and not prescribing benzodiazepines or opiates.
The one-third reduction is significant because it applies to people with opioid addictions, even if they are not actively seeking treatment.
“Even though treatment is really important, specifically medication assisted treatment, there are many people with opioid use disorders who don’t want treatment,” Dr. Katherine Watkins, a board-certified practicing psychiatrist, and lead author of the RAND study, told Healthline.
What works, what doesn’t
This research drew on a cohort of 32,422 individuals in the Veterans Affairs healthcare system from 2006 and 2007.
Watkins and her team studied seven major healthcare factors to examine what the effects would be on the mortality rate in people with opioid addictions.
The factors that assisted treatment included HIV screening, hepatitis screening, and medication.
But researchers concluded these therapies were not relevant in reducing mortality.
However, a third element, refraining from prescribing opioids and benzodiazepines, proved more complicated.
Watkins cautioned that both of these drugs, especially when used in tandem, could be fatal because they depress breathing and other basic functions of the central nervous system.
Benzodiazepines are commonly used to treat anxiety and panic disorders. However, like opioids, they are also sedatives.
Prescribing and re-prescribing opioids to someone dealing with opioid addiction is common and presents a unique dilemma for the healthcare community.
Healthline reported earlier this year on a study that concluded, “Approximately two-fifths (43 percent) of buprenorphine recipients filled an opioid prescription during the treatment episode, and two-thirds (67 percent) filled an opioid prescription following treatment.”
What this means is that even those in treatment for opioid addiction have a high likelihood of being prescribed these drugs anyway.
“Be really careful of these medications,” said Watkins. “We prescribe a lot of opioids for pain and sometimes opioids are really important for some people who have acute pain, but they are not good in people with chronic pain, and sometimes we prescribe too many in people with acute pain.”
This study did not establish a link between medication-assisted opioid addiction treatment —methadone, for example — and lower mortality rates.
“We know from other research that medication-assisted therapy can help people stay off drugs, get jobs, and lead more productive lives,” Watkins wrote in a press release. “But in this study, the treatment strategy was not associated with lower mortality.”
The reason, Watkins explained, is that while treatment tends to lower mortality rates in the long run for addicts, going on and off treatment are both linked with an increased risk of death.
That finding is confirmed in a study from the BMJ earlier this year.
“Probably the worst thing you could do is start and stop, start and stop, which is probably typical of what actually happens [during treatment],” said Watkins. “That’s really dangerous.”
However, this research should be encouraging to those dealing with opioid addiction, even if they elect not to pursue treatment, because it clearly identifies three steps users can take to become safer.
“If you know someone who is addicted to opioids, encourage them to get regular checkups with their doctor, even if they are not interested in treatment,” said Watkins.