Don't Underestimate The Patient When It Comes To Opioid Medication

Today's post from webmd.com (see link below) unfortunately adds somewhat to the hysteria currently surrounding opioid prescription for chronic pain. Yes the statistics are alarming and yes the potential for addiction is high if doctors don't have a serious follow-up program of control but the vast majority of patients with chronic pain, don't take opioids because they want to, they take them because all other alternatives have been exhausted and are not working. In that respect, opioids are an extremely useful and effective painkiller. They do require careful monitoring and that needs to be an active partnership between doctor and patient but the current assumption is that patients can't be trusted to do things properly and that is insulting to say the least. Nobody with chronic pain such as neuropathy wants to be addicted to a drug but everybody wants their symptoms to be reduced so that a normal life is possible. Under the right conditions, opioids can be very effective in doing that. Hopefully, common sense and not hysteria will rule the day.

Most Doctors 'Overprescribe' Narcotic Painkillers
By Alan Mozes HealthDay Reporter  WebMD News from HealthDay FRIDAY, March 25, 2016 (HealthDay News) 
 
While 99 percent exceed the recommended 3-day dosage limit, a quarter write prescriptions for a full month

-- When American doctors give their patients narcotic painkillers, 99 percent of them hand out prescriptions that exceed the federally recommended three-day dosage limit, new research suggests.

And some doctors exceeded that limit by a lot: Nearly one-quarter gave out month-long dosages, despite the fact that research has shown that a month's use of prescription narcotic painkillers can cause brain changes, the National Safety Council survey found.

"Opioids do not kill pain. They kill people," Dr. Donald Teater, a medical advisor at the safety council, said in a news release. "Doctors are well-intentioned and want to help their patients, but these findings are further proof that we need more education and training if we want to treat pain most effectively."

The problem has reached the point where these highly addictive painkillers, which include commonly prescribed drugs such as Oxycontin, Percocet and Vicodin, now account for more drug overdose deaths than heroin and cocaine combined, according to the report.

Unfortunately, the survey further revealed that while almost 85 percent of doctors screen for signs of prior narcotic painkiller abuse, just one-third ask about a family history of addiction. Only 5 percent offer direct help to patients when signs of abuse are uncovered, and less than 40 percent refer such patients for treatment elsewhere, the survey found.

The survey results, conducted in early March and released Thursday, come at a time when drug overdoses have reached record highs in the United States. Just this month, two federal agencies proposed measures to try to curb the narcotic painkiller abuse epidemic.

On Tuesday, the U.S. Food and Drug Administration ordered that warning labels be used for prescription narcotic painkillers. And last week, the U.S. Centers for Disease Control and Prevention issued tough new guidelines for doctors on prescribing these medications.

In December, the CDC announced that fatal drug overdoses had reached record highs in the United States -- driven largely by the abuse of prescription painkillers and another opioid, heroin. Many abusers use both.


According to that December report, more than 47,000 Americans lost their lives to drug overdose in 2014, a 14 percent jump from the previous year.

The safety council survey, of 200 doctors, found other troubling trends: Roughly three-quarters of doctors indicated that they believed that pain relief is best achieved by offering patients one of two opioids: morphine or oxycodone (Oxycontin). But experts from the safety council noted that over-the-counter pain relievers (including ibuprofen and acetaminophen) are more effective at providing short-term pain relief.

Misinformation particularly seems to be at play when it comes to tackling back pain and dental pain. While more than 70 percent and 55 percent of doctors say they prescribe narcotic painkillers for back pain and dental pain, respectively, these drugs are not considered the ideal treatment for either condition, according to the safety council.

Interestingly, the safety council found in an earlier survey that roughly half of all patients are actually more inclined to see their doctor again if non-narcotic painkillers are offered.
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http://www.webmd.com/mental-health/addiction/news/20160325/nearly-all-us-doctors-overprescribe-addictive-narcotic-painkillers-survey