Efforts to Reduce Opioid Prescribing May Be Causing Unintended Consequences for Terminally Ill Patients

According to data published this month by researchers at the Oregon State University College of Pharmacy, policies aimed at curbing opioid misuse might be having an unintended consequence: limiting access to pain-relieving medications for terminally ill patients.

The findings were published by the Journal of Pain and Symptom Management.

Researchers at Oregon State, Oregon Health & Science University, Dana Farber Cancer Institute, Ariadne Labs, University of Massachusetts Medical School and the University of Maryland School of Pharmacy reviewed electronic health records for 2,648 adult patients discharged to hospice care from 2010 to 2018. The average age of patients studied was 65, and more than half had cancer.

During the observed period, researchers saw a drop in opioid prescriptions as well as an increase in the prescribing of less powerful non-opioid alternatives. Adjusting for several factors that could affect prescription frequency, the study found a 12% drop in opioid prescribing for terminally ill patients.

CDC opioid prescribing guidelines for treating chronic pain, along with other federal, state and local efforts to reduce opioid prescribing may have had an unintended result, study lead author Jon Furuno, an associate professor and interim chair of the Oregon State Department of Pharmacy Practice, said in a news release.

“The CDC Prescribing Guideline and the other initiatives weren’t meant to negatively affect patients at the end of their lives, but few studies have really looked at whether that’s happening,” Furuno said. “Our results quantify a decrease in opioids among patients who are often in pain and for whom the main goal is comfort and quality of life.”