An article recently came out in Business Insurance detailing a study that revealed 10.4% of people with chronic pain who were prescribed opioids also tested positive for illegal drugs.
This sounded like a smoking gun on how opioids can often lead to addiction.
When I dug deeper, the data was a little surprising.
Of the total illegal drug users the study cited:
- 12.2% tested positive for marijuana;
- 2.0% tested positive for cocaine;
- 1.3% tested positive for heroin; and
- 125 samples tested positive for PCP and MDMA.
As it turns out, the majority of the people impacted were using marijuana.
In most cases, marijuana will clear a urine test within a month. I wanted to check on the overall adult US population usage of marijuana. Of the US population over 12, 9.4% used marijuana within the last month. That is only a 0.8% difference. If we remove the (under 16) population, who are likely not in the workers’ comp data, the margin is even narrower. There may be a slight correlation between opioid usage and an increase in marijuana usage, but it is very small.
Regular heroin use in the US is between 0.1% – 0.2% based on the studies I have seen. The 1.3% usage of the people in the study would be a 700 – 1300% increase over the general population. This is still a small percentage of opioid users in general that use heroin, but an obvious statistical increase. It stands to reason that a higher percentage of opioid users would seek out other types of opioids, such as heroin, so there is no real surprise in the data.
However, these numbers don’t even cover the main risk. We can see a correlation in heroin usage between opioid users and non-opioid users. What this study does not address is the greater threat posed for people who are cut off from their opioid prescription and their future illegal drug usage. These are the people that are far more likely to use heroin to continue to feed their addiction.
As always, the best solution is to manage and monitor treatment from early on so these people never become addicted. Industry programs such as our own have a very strong correlation between decreased opioid usage, and a shorter duration of disability. We all must continue to focus on finding better ways to get people healthy.