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When Is It Appropriate for Doctors to Prescribe Opioids?

By |July 24th, 2018|Categories: Opioid Crisis|0 Comments

The Centers for Disease Control and Prevention reported that in 2016, over 42,000 Americans died from opioid overdoses. About half of those deaths were caused by legal, prescription opiate painkillers, drugs that were supposed to help them treat their medical issues. Overdose deaths from prescription opiate medications have been a major issue and steadily increasing since they became popularized in the late 90’s.

These drugs that are supposed to improve our quality of life have contributed to an overall decrease of our quality of life and have reduced America’s average life expectancy.

In the medical community and in general, opioid painkillers are met with increasing controversy. It is difficult for doctors to identify when painkillers are truly necessary and appropriate in spite of the serious risks they carry. It is important for doctors to have basic rules and guidelines to know when it is appropriate to prescribe painkillers or when other treatment methods should be used.

Guidelines for Prescribing Opioids

American is unique in its use of prescription opioid painkillers as the go-to answer for pain related issues. In Germany and many other European countries, aspirin and ibuprofen are the most commonly used drugs for pain relief. The over-the-counter, low-strength pain relievers are vastly safer and less addictive than prescription painkillers. After a patient leaves the hospital after surgery or recovery for an illness, they are generally not given a prescription for OxyContin, Percocet, Vicodin or other heavy duty opioid drugs. Instead, they head to the local drug store and buy a bottle of ibuprofen, and/or purchase natural, holistic pain relief remedies.

America, on the other hand, is overly reliant on prescription medications for pain and virtually every medical issue. Although we have only 5% of the world’s population, we consume 80% of the world’s prescription drug supply. All countries other than the United States have relatively low prescribing rates for prescription opiates. In order to save lives and curb the addiction epidemic, we should follow the model of these other countries.

The difficulty for doctors is knowing when it is appropriate to prescribe these potentially dangerous opiate painkillers. In general, opiate painkillers should be limited for use only in an inpatient, hospital setting for acute pain. While there may be certain cases where patients need prescription painkillers outside of a hospital setting, these should be the exception to the rule and relatively rare. Painkillers may be necessary for patients undergoing certain surgeries where they are not sedated. The may also be necessary for surgery recovery or for recovery from an acute injury.

Other situations where painkillers might be necessary are with the terminally ill, cancer patients, and the critically sick or injured. If a person is in extreme, intractable pain, they may need powerful painkillers to simply be able to function. In the case of terminally ill patients, it may be necessary to take painkillers to be in comfort during whatever time they have left.

In general, the vast majority of painkiller prescriptions are not truly medically necessary. Patients currently taking powerful, highly addictive painkillers may be able to manage their pain through safer over the counter medicines and holistic treatments.

The majority of painkiller prescriptions are attributed to three categories. These are back pain, headaches, and dental pain. It is conspicuous to note that opiate pain relievers are not even intended to treat these issues. Over the counter pain relievers such as Advil, Motrin, and Tylenol are intended to and effective for treating these issues.

Most pain problems can be addressed through a combination of over the counter medications, rest, holistic remedies, proper diet, massage, and yoga. Instead, we rely so heavily on dangerous, highly addictive opioid painkillers and then wonder why we have an addiction epidemic.

Reducing Opioid Dependence

The nation’s opioid epidemic is driven primarily by prescription painkillers. Over the past two decades, prescription rates have increased by over 400%. Over the same span of time, overdose deaths and addiction treatment center admissions have also increased by 400%. It is crucial that doctors, hospital administrations, and patients unite to change the way that pain is addressed as a whole. By dramatically reducing painkiller prescription rates, we will dramatically reduce the scale of the addiction epidemic we are suffering from.

Sources:

https://labblog.uofmhealth.org/rounds/what-these-10-studies-taught-us-about-opioid-addiction-2017

http://theconversation.com/is-it-wrong-to-ask-your-doctor-for-opioids-91560

https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm529517.htm

https://www.washingtonpost.com/opinions/a-doctors-dilemma-do-i-prescribe-opioids/2016/06/10/be4bb51e-2c31-11e6-b5db-e9bc84a2c8e4_story.html

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