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.
