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Prince’s Reminder: Opioid Epidemic Intensifies But Steps to Curb It Face Challenges

| May 15, 2016

opiod epidemic

Lethal, in certain doses. (frankieleon)

The overdose death toll from opioids, both prescription drugs and heroin, has almost quadrupled since 1999. In 2014 alone, 28,000 people died of opioid overdoses, more than half from prescription drugs.

Just last month, public awareness of the opioid epidemic reached a new level when Prince was found dead with prescription narcotics on him and authorities began to investigate their role in his demise. In recent weeks, lawmakers and regulators have moved to augment treatment options for addiction and to require more education for doctors who prescribe opioids. The U.S. House of Representatives is voting on a package of bills this week; the Senate passed its own bill in March.

Also in that span, the Los Angeles Times has published an investigation of Purdue Pharma, the maker of the blockbuster pain pill OxyContin, and CNN held a town hallmeeting on the consequences of addiction to narcotics. Dr. David A. Kessler, former commissioner of the Food and Drug Administration, wrote an op-ed in the New York Times, calling the embrace of opioids “one of the biggest mistakes in modern medicine.”

Last week, ProPublica added warnings labels to the pages of narcotic drugs in our Prescriber Checkup news app, prompted by indications that some readers are using the tool to find doctors who will prescribe these drugs with few or no questions asked (See our editor’s note).

The effectiveness of any of these steps remains to be seen. There is broad consensus on the need for more treatment options, more education, more careful prescribing by doctors. But there’s still much debate about the details—and funding–for each of those steps.

What’s clear is that in recent months there has been an increasing emphasis on the role of health providers and the agencies that oversee them to stem access to widely abused prescription drugs:

  • In March, the Centers for Disease Control and Prevention released guidelines on prescribing of opioids for chronic pain, defined as pain that lasts for more than three months (excluding pain related to cancer, end-of-life and palliative care.) The guidelines call on doctors to choose therapies other than opioids as their preferred option; to use the lowest possible doses; and to monitor all patients closely.
  • That same month, the FDA announced tougher warning labels on immediate-release opioids, such as fentanyl, hydrocodone, and oxycodone, to note the “serious risks of misuse, abuse, addiction, overdose and death.”
  • Nonprofit groups and medical experts in April asked the federal Centers for Medicare and Medicaid Services to remove questions about pain control from a survey of hospital patients’ satisfaction to remove any incentive to overtreat pain. And they asked The Joint Commission, which accredits health facilities, to revise its standards to deemphasize “unnecessary, unhelpful and unsafe pain treatments.” The commission pushed back, saying its standards do no such thing.

Just yesterday, Dr. Steven J. Stack, president of the American Medical Association, called on doctors to do more. He encouraged doctors to use their state’s Prescription Drug Monitoring Program to ensure their patients aren’t shopping for multiple doctors to prescribe them drugs. He called on them to co-prescribe a rescue drug, naloxone, to patients at risk of overdose. And he told them to generally avoid starting opioids for new patients with chronic, non-cancer pain.

“As physicians, we are on the front lines of an opioid epidemic that is crippling communities across the country,” Stack wrote in a statement, published on theHuffington Post. “We must accept and embrace our professional responsibility to treat our patients’ pain without worsening the current crisis. These are actions we must take as physicians individually and collectively to do our part to end this epidemic.”

–Charles Ornstein, ProPublica

6 Responses for “Prince’s Reminder: Opioid Epidemic Intensifies But Steps to Curb It Face Challenges”

  1. anonymous says:

    Ppl that really need them can’t get anything because of the ones who abuse.

  2. Reality says:

    For over 6000 years the opium that is produced from the Poppie plant has been used both GOOD and BAD………Let me asked this. When you child or spouse is in so much pain that they would rather die, and your government has pulled all “pain meds” from the market….what will you give them ?

  3. Donald Trump's Tiny Fingers says:

    You know, a lot of the issues with prescription drugs could be remedied by making doctors consult with pharmacists to determine the best drug and dosage for their patients. Doctors aren’t pharmacists and don’t know drugs nearly as well as those whose job it is to.

    That said, the government isn’t pulling pain meds from the market, they’re pushing for more education and better labeling. So I guess the answer to Reality’s question above is “pain meds.” If you really need them then you should consult with someone certified in pain treatment and not your family practice doctor.

    Or you know, if they actually gave a crap about the deaths and wanted to pass meaningful legislation to decrease them, they could legalize cannabis. States that have legal medical cannabis see a 25% reduction in opioid-related deaths.

  4. Geezer says:

    I suffer from Rheumatoid Arthritis, diagnosed in 2004. Fortunately, I have a mild-to-moderate case.
    Even though it’s moderate at worst, (my case) RA is a sonofabitch as far as pain goes, with low-grade fevers
    and exhaustiion for dessert.

    Let’s see, I’ve been on NSAID’s like Daypro, Mobic, Celebrex, and these medicines eventually
    will give you an ulcer. I can no longer take these preparations for more than 2 – 3 days out of the month.
    I had some severe erosions, and almost a perforation of my stomach wall.

    OK now, then I was on Neurontin, Elavil, and Lyrica. Neurontin should be renamed as “Morontin” because of the effects on one’s cognition, same for Elavil and Lyrica. (these drugs work on the nerves, some are tricyclic anti-depressants) I would forget what I was going to say mid-sentance and was forgetful. You like romance?
    Cross that out whether you’re a guy or a girl. Nerve medicines will destroy intimacy with your spouse.

    The only medicines that I can tolerate for pain are of the opiate variety. I’ve been responsible with them, and
    take less than prescribed. They can be horribly addictive, once you pass the 2-pill per day dosage.
    I never exceed this amount, and because of this I haven’t developed a resistance. I also see a rheumatologist
    every month, and am voluntarily monitored.

    Percocet and Lortab therapy (2 popular opioids) require extensive monitoring of the patient.
    If you have a diagnosis of RA, fibromyalgia, severe disc degeneration, or cancer, you should never
    be denied these highly effective drugs.

    The trouble often starts with minor surgeries such as arthroscopic procedures of the knee or an ER visit.
    It’s OK to receive an RX for an opiod post-surgery or ER visit, and not to exceed 3-days-worth.
    Some people are going home with a 60 to 90-tablet supply after surgery! You will see legislation
    passed limiting quantities for non-chronic illnesses.

    There is a newer drug out there that’s an opiod, but without the “high.” (or less of a high)
    Nucynta is the name of the medicine, and it’s a better choice for people who are likely to abuse.
    And it’s an excellent option for long-term opioid use, such as with chronic diseases.
    Insurance doesn’t like to pay for it, though….

    Opiates aren’t going away. They are among the world’s most profitable drugs and used properly,
    they are life-savers.

    Doctors need to be more responsible when prescribing.
    Recently a doctor in California went to prison because 2 of her patients died from her over-prescribing
    of narcotics.

    People like being stoned, they’ll abuse anything including Robitussin.

    Remember “Angel Dust?” (PCP) Kids were actively dissolving this shit with embalming fluid,
    then infuse marijuana with the solution, and afterwards smoke it.
    Remember “Crack?” Huffing paint cans and plastic cement?
    How about good ‘ol alcohol which you can buy anywhere?

    Abusers will always come up with ways to get stoned.

    This is a “people problem.”
    THAT is the problem.

  5. Bc. says:

    Pull the pain meds from the market and all you will do is make the cartels very rich the Herion trade will be unstoppable. While folks in pain will suffer the drug addict will always find a way to get high. We have a border were drugs just flood into the USA. SO BAN THE leagl drugs and make the drug dealers rich and support there crime etc and all that goes with it.

  6. Geezer says:

    Since I was thinking about it–I thought I’d share a tip with you.
    Medical errors comprise a full third of fatalities in the USA.

    Think about it: out of every 900 deaths, 300 are the doctor’s fault!
    (or medical facility)

    If you’re on multiple drugs, always run them through an interaction checker
    such as:

    My doctor had me on a toxic mix that was going to rid me of my kidneys!
    Note: she’s not my doctor anymore.

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