Baltimore, MD—Pharmacists are filling many more prescriptions for opioids now than at the end of the last century, and a disturbing percentage of them are for long-term use.

That’s according to a new study from the Johns Hopkins Bloomberg School of Public Health, which determined that opioid prescription use jumped significantly between 1999 and 2014. Much of the increase was related to prescriptions for 90 days or longer, notes the article, published online by the journal Pharmacoepidemiology and Drug Safety.

Results of the review were based on data from the National Health and Nutritional Examination Survey, which the National Center for Health Statistics has conducted every 2 years since 1999–2000. Prescription opioid use increased from 4.1% of U.S. adults in 1999–2000 to 6.8% in 2013–2014, a 60% increase. At the same time, long-term prescription opioid use, defined as 90 days or more, increased from 1.8% in 1999–2000 to 5.4% in 2013–2014.

Of all opioid users in 2013–2014, 79.4% were long-term users compared with 45.1% in 1999-2000, according to the researchers, who point out that long-term use was associated with poorer physical health, concurrent benzodiazepine use, and history of heroin use.

“What’s especially concerning is the jump in long-term prescription opioid use, since it’s linked to increased risks for all sorts of problems, including addiction and overdoses,” explained study author Ramin Mojtabai, MD, PhD, MPH, a professor in the Department of Mental Health at the Bloomberg School. “The study also found that long-term use was associated with heroin use as well as the concurrent use of benzodiazepines, a class of widely prescribed drugs that affect the central nervous system,” he says.

Combining opioids and benzodiazepines significantly increases the risk of overdose, even if the patient is taking a moderate dosage of opioid medication, Mojtabai points out.

For the report, Mojtabai examined eight consecutive biannual surveys, each of which included over 5,000 adults living throughout the U.S. Interviews were conducted via computer in participants’ homes. Participants, totaling more than 47,000 over the eight surveys, were asked to identify prescription medications they had taken in the past 30 days, and for what length of time. The response rate ranged from 71% to 84%.

Opioid-medication use overall and long-term use was more common among participants on Medicaid and Medicare versus private insurance, noted Mojtabai, who added that no randomized clinical trials support opioids’ extended use, because of the risks.

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