The Opioid Dilemma in Cirrhosis: Deprescribing Rates Stubbornly Low
A large retrospective study of over 800,000 Medicare beneficiaries with chronic pain reveals that opioid deprescribing rates remain low, even among high-risk patients with cirrhosis. Despite guidelines recommending tapering, only about 37% of patients discontinued opioids after one year, with no significant difference between those with compensated, decompensated, or no cirrhosis. The study found that deprescribing rates were higher before the COVID-19 pandemic, and factors like non-opioid analgesic use, a history of falls, and frailty increased the odds of tapering, suggesting a complex interplay of pain burden and a lack of safe alternatives.
Why it might matter to you:
Managing chronic pain in patients with complex metabolic diseases like diabetes and its complications, including liver disease, is a frequent clinical challenge. This research highlights the systemic difficulty in reducing opioid reliance, even when indicated, which could inform your approach to managing pain in patients with diabetic complications. It underscores the need for integrated strategies that address both pain management and the underlying metabolic condition to improve patient safety.
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