Bibliometric Analysis of Academic Articles on Epidemic of Prescription Opioid Deaths, 1988-2017
Main Article Content
Purpose: The current study assesses how academic medical journals reflected the prescription opioid death crisis. The principal aim was to answer the question: How long did it take to reach definite bibliometric acknowledgment of deaths from opioid epidemic?
Methods: Death-related bibliometric indices were determined for opioids associated with increased mortality. The main of them is the percentage of articles on an individual opioid associated with death among all PubMed articles on that opioid. The bibliometric indices were followed for six 5-year periods, from 1988 to 2017. The time course for each of the indices were compared for two groups of opioids: 1) Those used for the treatment of chronic pain (“root cause of the epidemic”) – such as oxycodone, hydrocodone, and tramadol, and 2) Those which were always associated with the death due to addiction -- heroin and methadone. The difference in death-related bibliometric indices between these two groups of opioids was used as an indicator of changes in presentation of opioid deaths.
Results: The articles reporting death associated with oxycodone, tramadol, or hydrocodone became noticeable during 2003-2007, ten years after the beginning of epidemic (1993-1997). It was only in 2013-2017 mortality associated with these opioids were presented at the levels close to those of heroin or methadone. Only during 2013-2017 (twenty years after the beginning of epidemic) was death associated with oxycodone presented in journals as openly (in the article’s titles) as that associated with heroin, or methadone.
Conclusion: The danger of death from treatment of chronic pain with opioids was not properly appreciated for almost twenty years.
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
2. Okie S. A flood of opioids, a rising tide of deaths. N Engl J Med. 2010; 363(21): 1981-1985. doi: 10.1056/NEJMp1011512.
3. Dunn KM, Saunders KW, Rutter CM, Banta-Green CJ, Merrill JD, Sullivan MD, et al. Opioid prescriptions for chronic pain and overdose: a cohort study. Ann Intern Med. 2010; 152:85-92.
4. Kissin I. Long-term opioid treatment of chronic nonmalignant pain: unproven efficacy and neglected safety? J Pain Res. 2013;6:513-529.
5. Ballantyne JC. Opioids for the Treatment of Chronic Pan: Mistakes Made, Lessons Learned, and Future Directions. Anesth Analg. 2017; 125: 1769-1778.
6. Loeser JD. Five crises in pain management. International Association for the Study of Pain. Pain Clinical Updates. 2012; 20 (1): 1-4.
7. Tennant FS J, Uelmen GF. Narcotic maintenance for chronic pain. Medical and legal guidelines. Postgrad Med. 1983; 73:81-91.
8. France RD, Urban BJ, Keefe FJ. Long-term use of narcotic analgesics in chronic pain. Soc Sci Med. 1984; 19: 1379-1382.
9. Portenoy RK, Foley KM. Chronic use of opioid analgesics in non-malignant pain: report of 38
cases. Pain. 1986; 25: 171-186.
10. Kissin I. Can a bibliometric indicator predict the success of an analgesic? Scientometrics. 2011; 86:785-795
11. Kissin I, Bradley Jr EL. Top journal selectivity index and “me-too” drugs. Scientometrics. 2012; 91: 131-142.
12. Vlassakov KV, Kissin I. Scientometrics of anesthetic drugs and their techniques of administration, 1984-2013. Drug Des Devel Ther. 2014; 8: 2463-2473.
13. Kissin I. What can big data on academic interest reveal about a drug? Reflections in three major US databases. Trends Pharmacol Sci. 2018; 39: 248-257.
14. Paulozzi LJ, Budnitz DS, Xi Y. Increasing deaths from opioid analgesics in the United States. Pharmacoepidemiol Drug Saf. 2006; 15: 618-627.
15. Ahmad FB, Rossen LM, Spencer MR. Provisional drug overdose death counts-CDC. 2019. https://www.cdc.gov > nchs > nvss > vsrr > drug-overdose-data. Accessed September 17, 2019.
16. Kissin I, Gelman S. Chronic postsurgical pain: still a neglected topic? J Pain Res. 2012; 5: 473-489.
17. Barbuto JP. Beyond narcotics for effective pain management. J Manag Care Pharm. 2003; 9: 175-176.
18. McLellan AT, Turner B. Prescription opioids, overdose deaths, and physician responsibility. JAMA. 2008; 300: 2672-2673.
19. Rathmell JP, Miller MJ. Death after initiation of intrathecal drug therapy for chronic pain: assessing risk and designing prevention. Anesthesiology. 2009; 111: 706-708.
20. McLellan AT, Turner, BJ. Chronic noncancer pain management and opioid overdose: time to change prescribing practices. Ann Intern Med. 2010; 152: 123-124
21. Fishman SM. Prescription drug monitoring programs serve a vital clinical need. Pain Med. 2011; 12: 845.
22. Dhalla IA. Opium, opioids, and an increased risk of death. BMJ. 2012; 344: e2617.
23. Lipman AG. Opioid poisoning deaths. J Pain Palliat Care Pharmacother. 2012; 26: 308-309.
24. Katz MH. Opioid prescriptions for chronic nonmalignant pain: driving on a dangerous road. JAMA Intern Med. 2013; 173: 178.
25. Berge KH, Burkle CM. Opioid overdose: when good drugs break bad. Mayo Clin Proc. 2014; 89: 437-439
26. Middleton J, McGrail S, Stringer K. Drug related deaths in England and Wales. BMJ. 2016; 355: i5259.
27. Burke DS. Forecasting the opioid epidemic. Science. 2016; 354 (6312): 529.
28. Mahan KT. The Opioid Crisis. J Foot Ankle Surg. 2017; 56: 1-2.
29. 2021 AMA overdose epidemic report. Press release Sep 21, 2021. Available at https://www.ama-assn.org. Accessed October 21,2021.
30. Kissin I. Scientometric assessment of drugs for chronic pain. 1979-2013: rapid growth of publications, paucity of successful drugs. J Pain Res. 2014; 7: 505-514.
31. Kissin I. The development of new analgesics over the past 50 years: A lack of real breakthrough drugs. Anesth Analg. 2010; 110:780-789.