A new study looks at which patients prescribed a short course of narcotic painkillers may be most prone to long-term abuse.
The study finds - perhaps not surprisingly - that people with prior histories of drug abuse, or current or former smokers, were much more likely to go beyond that short-term prescription.
Read: Can painkillers be addictive?
The drugs in question are "opioid" painkillers such as oxycodone (Oxycontin), hydrocodone (Vicodin), codeine and methadone, among others.
The study was led by Dr W. Michael Hooten, an anesthesiologist at the Mayo Clinic in Rochester, Minn. His team tracked outcomes for nearly 300 patients given a first-time, short-term prescription for one of this class of narcotic painkillers in 2009.
The investigators found that nearly one in every four of the patients continued to take the medication for extended periods of time.
Read: The most abused over-the-counter drug in SA
Specifically, the study found that 21 percent of short-term opioid patients end up getting prescriptions that extend for as much as three to four months. Another 6 percent actually continued the medications for longer than four months.
People with a prior history of either smoking and/or drug abuse appear to be at greatest risk for turning a short-term pain treatment into a long-term drug abuse problem.
Why? Hooten's team believes that addiction to nicotine or other substances may have the same effect on the brain as using the narcotic painkillers.
"Many people will suggest [painkiller abuse is] actually a national epidemic," Hooten said in a Mayo news release. "More people now are experiencing fatal overdoses related to opioid use than compared to heroin and cocaine combined," he added.
Read: Youth gets high on cough medicine
Patients must learn "to recognise the potential risks associated with these medications," Hooten said. For some patients, "I encourage use of alternative methods to manage pain, including non-opioid analgesics or other non-medication approaches," he said.
Avoiding narcotic painkillers "reduces or even eliminates the risk of these medications transitioning to another problem that was never intended," Hooten said.
His team published their findings in the July issue of the Mayo Clinic Proceedings.
"The next step in this research is to drill down and find more detailed information about the potential role of dose and quantity of medication prescribed," Hooten said. "It is possible that higher dose or greater quantities of the drug with each prescription are important predictors of longer-term use."
There's more on abuse of opioid painkillers at the US National Institute on Drug Abuse.
The different groups of painkillers
SA implements 5 year plan to end drug abuse and trafficking
Oral 'nicotine fix' may be safer than cigarettes