Prescription opioid misuse: improving prevention and treatment

In the United States, misuse of opioid analgesics has led to widespread societal problems, including criminality, violence, addiction, transfer to the use of heroin, overdose, and mortality.

In Sweden, most opioids for pain relief are prescribed in primary care, and prescription of strong opioids has significantly increased.

It is crucial to bring opioid prescription into closer adherence to national guidelines and policies so that Sweden does not experience an opioid epidemic.

Treatment of opioid misuse differs across countries and is typically provided by social services, primary care, and specialized psychiatry. Many who become addicted recover, but a substantial number drop out of treatment, and mortality is high.

Currently, we lack data on outcomes and prognostic factors - including genetics - needed to improve and personalize interventions.

This project aims to prevent misuse of prescription opioid analgesics and improve interventions for people dependent on these prevalent and highly addictive narcotics, addressing two knowledge gaps defined by SBU.Work Package 1 aims to prevent prescription opioid misuse, especially by young and new users.

This RCT will investigate whether a new educational program with online feedback of quality indicators for primary health care physicians can reduce prescription of opioid analgesics by improving adherence to guidelines and policies for pain management.Work Package 2 aims to improve and personalize treatment for people addicted to prescription opioid analgesics.

It has two parts: 1) a cohort study to evaluate outcomes of tapering for people with addiction to opioid analgesics and 2) a national quality register study on the outcomes of opioid maintenance programs for people with the most severe addictions.The research group includes specialists in epidemiology, addiction research, genetics, pain management, primary health care, psychology, and the user perspective.