Every day in the United States 44 people die from overdoses of prescription painkillers, more than quadruple the number they were just 15 years ago. According to the U.S. Centers for Disease Control, the crisis is an epidemic, with more people dying from prescription opioid overdoses than heroin, cocaine and all other drugs combined.
Opioids are used to treat pain, especially for post-surgical relief, chronic severe back paid and end-of-life care. Oxycodones and hydrocodones are two of the most common forms and they are powerful narcotics. Americans are the top consumer of these drugs, accounting for almost 100 percent of all hydrocodone prescriptions and 81 percent of oxycodone prescriptions throughout the world. More than 2 million Americans are addicted to these narcotics.
Problem Can Be Fixed
According to Kaiser Permanente, the problem of opioid addiction can be addressed at multiple angles.
Misinformation about the use of opioids for chronic, non-cancer pain was a key driver of widespread overuse and abuse in the U.S.
Kaiser Permanente physicians developed up-to-date evidence-based treatment guidelines for the proper use of these medications. Guidelines include:
- Focusing on alternatives to opioid therapy as a first-line treatment for chronic, non-cancer pain;
- Providing non-drug treatment options (such as meditation, guided imagery, and Tai Chi);
- Treating patients with the lowest dose of opioids possible, for the shortest duration necessary (in general, less than a 100 mg morphine equivalent dose per day, with no more than a 30-day supply at a time);
- Monitoring patients at risk for opioid abuse via questionnaires, urine drug tests, and prescription history on state prescription drug monitoring databases;
- Recognizing “red flag” behaviors that suggest dependence, misuse, or abuse (such as the need for escalating dosages, requesting refills before they are due, or requesting name-brand drugs, which carry a high “street” resale value); and,
- Using documentation tools to ensure communication and collaboration within and across specialties.
Doctors Can Help
The Huffington Post quoted Dr. W. Michael Hooten, a Mayo Clinic pain specialist, saying, “Before you provide an opioid prescription to a patient, it’s important to recognize that if they have a tendency to abuse substances, you should have a heightened sense of vigilance.”
The Post also quoted, Dr. Andrew Kolodny, an expert in opioid addiction, saying, “These are extremely important medicines for end-of-life care. I think they play a very important role when used short-term — for a few days after major surgery or a serious accident, for example. But using them long-term is a very bad idea.”
Kenneth Artz ([email protected]) is managing editor of Health Care News.
Samantha DuPont, Athan Bezaitis, and Murray Ross, “Stemming The Tide Of Prescription Opioid Overuse, Misuse, And Abuse,” Health Affairs Blog, September 22, 2015:
Joe Satran, “Doctors Play A Role In The Opioid Addiction Epidemic, Study Finds,” The Huffington Post, September 4, 2015: