Americans Still Receive Too Many Opioid Painkillers
It’s a familiar story. We’ve heard it time and time again. An ordinarily healthy person suffers chronic pain due to an injury, acute illness, or surgery. To reduce the patient’s pain, a doctor prescribes the individual an opioid, such as OxyContin, Vicodin, Morphine, or Percocet (just to name a few).
Unfortunately, this is where the trouble begins. Because opiate painkillers are addictive, it’s not long before the patient builds up a tolerance to the drugs, and requires more pills to get the same effects from them. This results in a physical dependence, meaning that withdrawals can come about if the patient does not continue taking their meds every day.
Other risk factors set in, like self-medication, the risk for overdose, excruciating withdrawal symptoms, medications no longer serving to reduce pain, seeking drugs from other sources, doctor shopping, etc.
And all of that difficultly and struggle began with an innocent patient seeking pain relief from a doctor.
Sadly, this story has become commonplace across America as prescription opioids, which are dangerous and addictive drugs, are increasingly used as the alleged “solution” to physical pain. But they are not a solution at all.
Is it time to take a serious look at sharply curbing opioid prescribing? Might it be life-saving to do so?
Curbing Opioid Prescribing
Weren’t these trends reduced already? The simple answer? Yes. Opioid prescribing reached its peak almost half a decade ago. But even though prescribing trends have receded slightly, opioid prescribing is still far above the levels of the 1990s (prior to the opioid painkiller production boom). And according to one report by the Washington University School of Medicine, as much as 20 percent of all opioid pills prescribed in the United States are actually taken for other than medical reasons. That means one out of every five pain pills made by pharma companies are going directly into the hands of addicts and pill abusers.
What the CDC is Saying Regarding Ethical Opioid Prescribing
Perhaps the best place to look for verified and authoritative data on ethical and conservative opiate prescribing is the Centers for Disease Control and Prevention. The CDC put together a report on just this subject in 2016. Some of the highlights of the report include advice such as the following:
Nonpharmacologic therapy and nonopioid pharmacologic therapy are almost always preferred for treating chronic pain. Pharmacological treatment should only be used to treat pain if the patient has already exhausted all nonpharmacologic and nonopioid pain relief options.
Physicians and other prescribers should always go over the risks of opioid painkillers with their patients. Patients need to understand that about one in five painkiller pills ends up being misused, indicating that any patient has a 20 percent chance of misusing their prescriptions.
“Clinicians should use caution when prescribing opioids at any dosage, should carefully reassess evidence of individual benefits and risks when considering increasing dosage...”
If physicians must prescribe opiates, they should only prescribe the absolute minimum amount of opiates for the minimum amount of time. Quoting the CDC report directly, “Clinicians should use caution when prescribing opioids at any dosage, should carefully reassess evidence of individual benefits and risks when considering increasing dosage to ≥50 morphine milligram equivalents (MME)/day, and should avoid increasing dosage to ≥90 MME/day or carefully justify a decision to titrate dosage to ≥90 MME/day.”
Physicians should always schedule follow-up appointments with their patients. They should evaluate potential benefits and harms, and they should discontinue opioid prescribing as soon as possible, especially if the disadvantages outweigh the benefits.
Clinician reminders include:
- Opioids are not first-line therapy for treating pain.
- Patients must always be able to give informed consent on any prescribing.
- Low dosages for short durations are critical.
- Discontinue opioids as soon as possible.
- Avoid concurrent opioid prescribing with benzodiazepines and other medications that react poorly with opioids.
What is Informed Consent?
One of the keys to reducing the ongoing overprescribing of opioids is to ensure that patients know precisely the risks in the drugs they are being prescribed. That is informed consent.
Securing a patient’s fully informed consent regarding the use of opioid painkillers as a pain treatment approach is crucial. Informed consent allows the patient to become fully informed on the drug they are about to take. Informed consent means the doctor will tell the patient about all of the drug’s risks, including addiction risk and overdose risk.
Informed consent has become so crucial that full guides have been created for both providers and patients on how to achieve it.
The problem with opioid prescribing is that, more often than not, patients are not given an honest disclosure of the actual degree of risk connected to opioid pain relievers. For example, most patients are not told that hundreds of thousands of Americans have died from opiate painkillers since 1999.
Another point to consider is the importance of individual patients taking responsibility for learning what the risks are in taking any drug they are being encouraged to take by their doctor. Doctors have a responsibility and a role to play, in protecting their patients from harm. But patients need to protect themselves, too.
Addiction Treatment – What to Do if a Loved One Becomes Addicted to Their Painkiller Meds
It is a sad day in the modern world when the very medicines intended to help people with reducing their pain end up being addictive and potentially lethal. Over the past two decades, millions of Americans have become hooked on drugs they were promised would help them. Thousands died as a result of overdoses on such pills.
If you know someone who is addicted to opiate painkillers, it’s crucial that you do everything you can to help them get into treatment and get off of painkillers. Painkiller addiction is a potentially lethal crisis. There are other, healthier means of treating physical pain. Don't let your loved one become yet another unnecessary death at the hands of the opioid epidemic. Call Narconon today to learn more about how the program can help your loved one get off of drugs for life.
Reviewed and Edited by Claire Pinelli, ICAADC, CCS, LADC, RAS, MCAP