OPIOID PREVALENCE

OPIOID USE IS COMMON AMONG PATIENTS WITH OA AND RA

In two studies that each compared >240,000 U.S. patients:

40%
of RA patients used opioids regularly5‡

17%
of any joint OA patients were prescribed opioids for their condition6§¶

Based on a study of 2014 Medicare data in the average rheumatologist’s practice.
§According to data from the Humana, Inc. administrative claims database from 2007 to 2014.
13% of patients with hip OA and 16% of patients with knee OA were prescribed an opioid.
CDC=Centers for Disease Control and Prevention; DMARD=disease-modifying antirheumatic drug; NSAID=nonsteroidal anti-inflammatory drug; OA=osteoarthritis; RA=rheumatoid arthritis.

OPIOID LIMITATIONS

OPIOIDS DO NOT ADDRESS INFLAMMATION AND HAVE UNWANTED CONSEQUENCES

Opioid pain relievers:

Electricity

Are not designed to target inflammation7-9

Person on toilet

Can cause sedation, respiratory distress, and constipation10

neuron

Act on the nervous system10

Rx pad

Are controlled substances11

Medication

Can cause addiction, dependence, and tolerance10

EXPERT RECOMMENDATIONS

CDC GUIDELINES STATE THAT OPIOIDS SHOULD NOT BE CONSIDERED FIRST-
LINE OR ROUTINE THERAPY FOR CHRONIC PAIN1*

Physicians should:

  • Use nonopioid therapies to the extent possible
  • Focus on functional goals and improvement, engaging patients actively in their pain management
  • Use first-line medication options preferentially

NSAIDs provide non-narcotic and non-addictive relief from the signs and symptoms of OA and RA, including inflammation and pain12-14

Low-dose prednisone is non-narcotic and can be added to DMARD therapy to provide relief from the signs and symptoms of RA, including inflammation and pain15

*Non-opioid pharmacologic therapy options carry certain risks and may not be appropriate for certain patients; physicians should assess whether the benefits of non-opioid pharmacologic therapy outweigh the risk.
Outside of active cancer, palliative, and end-of-life care.1

Make sure you prescribe the right
therapy

icon RAicon RAicon RA

Consider the need for gastroprotection with NSAID therapy

See the data
icon_researchicon_researchicon_research

Review the research on NSAID-related systemic exposure

Get the facts

  • Centers for Disease Control and Prevention. Nonopioid treatments for chronic pain. Centers for Disease Control and Prevention website. https://www.cdc.gov/drugoverdose/pdf/nonopioid_treatments-a.pdf. Accessed June 14, 2020.
  • Centers for Disease Control and Prevention. CDC guideline for prescribing opioids for chronic pain. Centers for Disease Control and Prevention website. https://www.cdc.gov/drugoverdose/pdf/prescribing/Guidelines_Factsheet-a.pdf. Accessed June 14, 2020.
  • U.S. Department of Health and Human Services. What is the U.S. opioid epidemic? U.S. Department of Health and Human Services website. https://www.hhs.gov/opioids/about-the-epidemic/index.html. Accessed June 14, 2020.
  • National Center for Injury Prevention and Control. Annual surveillance report of drug-related risks and outcomes. Centers for Disease Control and Prevention website. Published November 1, 2019. Available at: https://www.cdc.gov/drugoverdose/pdf/pubs/2019-cdc-drug-surveillance-report.pdf. Accessed June 14, 2020.
  • Curtis JR, Xie F, Smith C, et al. Changing trends in opioid use among patients with rheumatoid arthritis in the United States. Arthritis Rheumatol. 2017;69(9):1733-1740.
  • DeMik DE, Bedard NA, Dowdle BS, et al. Are we still prescribing opioids for osteoarthritis? J Arthroplasty. 2017;32(12):3578-3582.
  • OXYCONTIN (oxycodone hydrochloride) [prescribing information] Purdue Pharma L.P.
  • NORCO (hydrocodone bitartrate and acetaminophen tablets) [prescribing information] Allergan USA, Inc.
  • Pathan H, Williams J. Basic opioid pharmacology: an update. Br J Pain. 2012;6(1):11-16.
  • Jamison RN, Mao J. Opioid. Mayo Clin Proc. 2015;90(7):957-968.
  • Drug Enforcement Administration (DEA). Drug Fact Sheet. Narcotics. Drug Enforcement Administration website. https://www.dea.gov/sites/default/files/2020-06/Narcotics-2020.pdf. Accessed June 14, 2020.
  • Bannuru RR, Osani MC, Vaysbrot EE, et al. OARSI guidelines for the non‐surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage. 2019;27(11):1578‐1589.
  • Crofford LJ. Use of NSAIDs in treating patients with arthritis. Arthritis Res Ther. 2013;15(suppl 3):S2.
  • DUEXIS (ibuprofen and famotidine) [prescribing information] Horizon.
  • RAYOS (prednisone) delayed-release tablets [prescribing information] Horizon.