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America's Opioid Crisis Facts

November 20, 2017

Opioids: this word alone can cause many negative sentiments to arise in people because of the devastating effects that the improper prescribing of these harmful substances can cause.  According to an article in The New York Times, this August President Trump officially acknowledged the opioid epidemic as a national emergency.  The same article states that according to several government briefs published this year, in 2014 almost 1.3 million hospitalizations dealing with opioids took place in the United States.   

The Centers for Disease Control and Prevention (CDC) has issued new guidelines as of March 18, 2016, and they have put together recommendations for doctors who prescribe these drugs.  The CDC has separated these recommendations into three groups:

Determining when to initiate or continue opioids for chronic pain 

Nonopioid therapy is favored for chronic pain.  However, if opioid therapy is started for this type of pain, clinicians should create treatment goals and conduct an analysis throughout the treatment to ensure that treatment is stopped if the benefits do not outweigh the risks at any point.  Before starting and at times throughout opioid treatment, physicians should discuss with patients the risks and benefits of the therapy and talk with the patients about what both their personal responsibilities and the physician’s responsibilities are for handling this type of therapy.

Opioid Selection, Dosage, Duration, Follow-Up and Discontinuation  

When starting a patient on opioid therapy for chronic pain, immediate-release opioids should be used versus extended-release opioids.  When a patient is started on opioids, clinicians should prescribe the lowest effective dosage.  They should exercise caution when prescribing opioids at any dosage.  When opioids are prescribed for acute pain, clinicians should use the lowest effective dose of immediate-release opioids.  Benefits and harms should be evaluated, and if the harms outweigh the benefits, clinicians should either taper opioids to lower dosages or taper and discontinue. The clinician should only prescribe the opioid for acute pain for 3 days. In rare instances, 7 days may be needed.

Assessing Risk and Addressing Harms of Opioid Use 

Clinicians should look over the patient’s chart of controlled substance prescriptions.  They should perform drug testing on patients before starting them on opioids and at least annually afterward.  They should avoid prescribing opioid paid medication and benzodiazepines at the same time whenever possible.  Physicians should offer or organize treatment for patients with opioid use disorder.

If you or a loved one have become addicted to opioids and you feel that the doctor has violated the above recommendations, please call our office for a free consultation.  It is important to act swiftly regarding this matter because of the potentially severe and sometimes lethal consequences that opioid abuse can have.