The Powerful Highly-Addictive Drug
The Centers for Disease Control and Prevention is advising doctors to cut back on the dose and length of opioid prescriptions for pain when possible. The agency released 12 recommendations for doctors and other health care prescribers in March.
Prescription opioids are powerful, highly-addictive drugs such as oxycodone, hydrocodone, and morphine. A drastic increase in prescriptions for opioids in the 1990s and 2000s led to increases in the number of overdoses in the United States.
Painkiller Guidelines
The CDC’s 12 guidelines were guided by three overarching principles:
- Nonopioid pain medications are preferred over opioids for treating chronic pain that does not involve cancer or palliative care.
- Doctors should prescribe the lowest effective dosage when prescribing opioid medications.
- Prescribers should monitor patients receiving opioid medications.
The CDC’s recommendations came after months of public comment, debate and discussion over how doctors can help reduce the prevalence of opioid addiction.
Opioid-Related Deaths
More than 28,000 people died opioid-related deaths in 2014, accounting for 61 percent of all drug overdose deaths. Previous research indicates that a large number of patients suffering from opioid addiction were introduced to the drugs by doctors who carelessly prescribed opioid-based pain medications.
The CDC is now recommending doctors prescribe immediate-release opioids instead of extended-release opioids when possible. Extended-release opioids are designed to slowly dissolve in the body for eight to 12 hours, but drug users can abuse the drugs to receive the full effect instantly.
The agency also advised clinicians that three days is usually sufficient for treating acute pain, and the need for seven days of treatment is rare.
Chronic Pain Recommendations
For chronic pain, the CDC recommends doctors evaluate the benefits and harms to the patient within four weeks of beginning opioid therapy. Other recommendations include assessing a patient’s history of illness and drug abuse before prescribing opioids
In 2016, the federal government has been actively pursuing initiatives to reduce opioid deaths. In February, President Barack Obama requested $1.1 billion to combat the opioid epidemic. The administration’s plan included increasing access to opioid overdose reversal drugs such as naloxone, expanding access to treatment providers and evaluating the effectiveness of medication-assisted treatments.
Comprehensive Addiction and Recovery Act of 2016
In August, the president signed the Comprehensive Addiction and Recovery Act of 2016. The bipartisan legislation helps fund community-based coalitions, educational efforts, law enforcement reform and expanded access to recovery solutions.
Several critics of the law say it doesn’t include enough funding to achieve its goals, but supporters say Congress has the opportunity to find funding in the future.
By Chris Elkins
Chris Elkins writes for DrugRehab.com — a comprehensive resource for addiction-related topics, from substances that cause addiction to treatment options for recovery.
Sources:
- Centers for Disease Control and Prevention. (2016, March 15). CDC Releases Guideline for Prescribing Opioids for Chronic Pain.
- Congress.gov. (2016, July 22). S.524 – Comprehensive Addiction and Recovery Act of 2016.
- Dowell, D., Haegerich, T. M. & Chou, R. (2016, March 15). CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016.
- Tavernise, S. (2016, March 15). C.D.C. Painkiller Guidelines Aim to Reduce Addiction Risk.
- The White House. (2016, February 2). Fact Sheet: President Obama Proposes $1.1 Billion in New Funding to Address the Prescription Opioid Abuse and Heroin Use Epidemic [Press release].
I’m Victoria B. and I write this blog for fun and for free. My day job is over at 800 Recovery Hub
800 Recovery Hub Blog 
The last thing I want between me and my doctor is a freaking bureaucrat. That said, I’m one of those who won’t even fill a prescription of an opioid. No pain is worth the misery that would follow.
LikeLiked by 1 person
Amen! I get so frustrated with politicians meddling with my personal health decisions. I only take medical suggestions and guidance from doctors. You right, the consequences are not worth the price.
LikeLike
oh my Gosh, They are taking away all the therapeutic medicines that I have build my life on!!!
LikeLike
Do you have a good doctor?
LikeLike
i was just kidding… 🙂
LikeLiked by 1 person
Oh in that case awesome …. I just love that kind of humor. I just never know. Yesterday, someone got way too sensitive and took my friendly and (I thought) loving advice and called me rude and condescending. Yikes. Can’t we have a bit of fun around here?
LikeLiked by 1 person
I have done my share when I was a student…fortunately didn’t continue after graduation 🙂
LikeLike
The problem with “leaving it to the doctors” as the comments say, is that the primary care doctors were told by both pain specialist physicians and patient advocates that they should treat chronic pain with opiates for years. And physicians were sued for “inadequate pain treatment”. I was unenthused about chronic opiates and sent people to a pain specialist when they got over my very low limits. People came back on much higher doses and with nearly identical pain complaints. Remember that medicine is a moving target because the information changes. We must be careful with any medicine or substance that is addictive: with opiates, the myth was “taking it as prescribed for pain keeps people from becoming addicted”. Then if a patient did have an overuse problem, they were labelled an addict who misused it. We need to stop assigning blame and keep people from overdose deaths and the patients on chronic high dose opiates can be weaned to lower safer doses, but it takes two years and patience and kindness both on the part of the physician and the patient. Thank you for this post.
LikeLiked by 1 person
Sounds like you were put in a position of “no-win” Thanks for sharing your experience and expertise.
LikeLiked by 1 person
A patient said to me that my most important job was to treat his pain. I replied, “No, that is my second most important job. My most important job is to not kill you.”
LikeLike
I just adore you. Bravo doctor. You are one of the medical professionals that really “get it”. Your patients are blessed to be in your care.
LikeLiked by 1 person
Thanks for posting this. I live in Germany and suffer from chronic pain. I will never be offered opiates I think. They are very conservative here. I have been told that addiction is still an issue but I don’t hear about ODs here like I so from the US (though I am kind of on the outside of things being an immigrant). Sometimes I am frustrated because nothing helps with the pain, but when I hear about the problems with opiates in the US I think maybe the better safe than sorry route here isn’t so bad. In fact, they don’t like to subscribe sleeping tablets or much of anything really. Just in case. Ironically, this is a county that has festivals focussed on beer….Still, I think the negligent prescribing is probably a result of frustration on the doctor’s part. Chronic pain is nothing you can understand unless you live with it…just as I imagine is the same as having an addiction. Maybe some doctors truly want to help the sufferer find relief. Others maybe just want to shut them up and not deal with the complaints. When there are no good options, too often people accept the bad ones. I wish I had one to offer.
LikeLike
Wow, that is great information. I think that if people never were offered opioids, they would never know what they are missing. It sounds very cleaver. It reminds me of our childhood experiences. If you are poor when you are a small child, you have no idea, because you have no comparison.
LikeLike
The easiest way to stop something bad for you is not to start, they say! I wanted to edit my typos but can’t. That is hard enough for my control issues. I don’t think I could handle trying to come off of something so powerful.
LikeLiked by 1 person
Thanks Leah. I think that is such a powerful yet practical saying. By the way, I didn’t even notice any typos.
LikeLike