High-Dose Opioid Prescriptions Linked to Higher OUD Risk

Patients on high-dose opioids face increased addiction risks, while physical therapy may help lower that risk.

Updated on Oct. 28, 2026 in Substance Abuse

High-Dose Opioid Prescriptions Linked to Higher OUD Risk

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Would you prefer non-drug treatments over opioids to manage new back pain to avoid addiction risks?

A new study of nearly 400,000 adults shows that higher-dose opioid prescriptions and certain medication combinations are linked to a significantly higher risk of opioid use disorder or overdose. Accessing non-pharmacological pain management, such as physical therapy or chiropractic care, may be associated with a reduced risk for these outcomes.

Why it matters

Understanding the factors that influence the risk of opioid use disorder is essential for patients navigating pain management. This research underscores how prescribing patterns and complementary treatments can significantly shift the safety profile of a pain treatment plan.

In a retrospective cohort study of 399,500 opioid-naive adults, researchers analyzed Medicaid data from 2016 to 2019 to identify factors linked to opioid use disorder or overdose. Findings indicate that higher-dose opioid use is associated with a 146.6% increased risk, while lower-dose use for more than 7 days and gabapentinoid use carry significant risk increases.

The details

Researchers utilized data from the Transformed Medicaid Statistical Information System to track outcomes based on prescription levels and concurrent treatments. High-dose prescriptions exceeding 50 milligrams of morphine equivalents daily were linked to a twofold risk for new-onset disorders. The study defined primary outcomes through clinical diagnosis codes for opioid use disorder, nonfatal unintentional overdoses, or specific medication-assisted treatment prescriptions.

2014 was the deadline for states adopting Medicaid expansion for study inclusion.
Data collection for the cohort study occurred between 2016 and 2019.
The study was published on October 19, 2026.

Health Landscape

This research builds on longitudinal analysis within the Transformed Medicaid Statistical Information System to evaluate population-level risks in pain management. It highlights a critical shift toward integrating non-pharmacological care as a protective strategy against opioid-related harms.

If you are prescribed pain management medication, consider asking your physician about the potential risks of the dosage and whether non-pharmacological options like physical therapy might be appropriate for your condition. It is also worth discussing any concurrent medications, such as gabapentinoids, to understand how they may affect your overall safety profile.

The takeaway

Higher-dose opioids and concurrent use of gabapentinoids are linked to a significantly elevated risk of opioid use disorder or overdose. If you are managing pain, ask your doctor about evidence-based non-pharmacological alternatives such as physical therapy or chiropractic care.