Opioid addiction and overdose death growth rates terrify the general populace, overwhelm medical and social service communities, alert law enforcement, challenge governments, and build pulpits for politicians. Finger pointing at pill-count-driven pharmaceutical companies in collusion with script-eager physicians is one easy response, as is calling for stricter law enforcement. One theme that plays often in conversation about the causes of our current rapid growth in opioid abuse is pain management associated with back or other structural injuries or disease. It turns out the assumption that many people sent home with opioid prescriptions take too much, get hooked, and then obtain drugs from the pharmaceutical street trade where their problem becomes much worse, with fatal endings too common, may be overstated.
A team headed by researchers at the Harvard’s Brigham and Women’s Hospital Division of Medical Toxicology, Department of Emergency Medicine in Boston, Massachusetts used ingestible biosensors within standard size gel capsules containing 5mg of oxycodone to track opioid usage by patients discharged from hospitals following treatment for severe broken bones. The bio sensor is activated by the chloride ion gradient in stomach acid and emits a radio frequency signal. A reader attached to a patch worn by the patient receives the sign and in turn sends the ingestion data to a cloud-based server for storage and analysis. The conclusion from the study was that the patients ingested less opioid medication than was previously thought.
The BWH study cannot be taken as the final word on the subject of opioid abuse related to pain med prescriptions. The sample number is small; only 15 of 16 patients enrolled in the study finished it. There was no control group. The study was anything but blind; the patients knew what was going on and why. For the BWH data to be useful, the study must be replicated multiple times for validity and reliability, with additional design improvements. Still, the results are interesting and point the way toward a better understanding of patient behaviors related to pain management medications. Perhaps they will lead to new understandings that could help stem the tide of opioid addiction.