Opiates are Overprescribed to Mother’s After C-Sections
September 20, 2017
Three recent medical studies all suggest that new mothers may be prescribed opioids at too high of a rate after having Cesarean, or C-Sections. With evidence regularly proving how deadly and dangerous opioid painkillers can be, along with rates of addiction and overdose rapidly increasing across the United States, it is critical that doctors practice caution and avoid overprescribing these medications to vulnerable patients who could quickly become dependent on these extremely addictive medications.
According to the National Institute on Drug Abuse (NIDA), an estimated 2.1 million Americans are addicted to prescription opioids. These drugs are highly dangerous to ingest – in fact, the rate of accidental overdose deaths has more than quadrupled in less than 20 years. In 2015 alone, more than 15,000 people died after overdosing on opioids and every single day, over 1,000 Americans are treated in emergency departments for misusing them. The Centers for Disease Control and Prevention (CDC) estimate that as many as 1 in 4 people who take opioids long-term may become addicted.
With so many people becoming dependent on opioids, why do doctors continue to write prescriptions for patients if the risks clearly outweigh the benefits? NIDA reports that the aggressive marketing tactics of behalf of pharmaceutical companies are largely to blame, as well as the increase in social acceptability of using prescription medications for pain treatment and other medical conditions.
Delivering a child by C-section entails a surgeon operating on a mother by cutting through the wall of her abdomen. The procedure is extremely common, with roughly 1.3 million being performed annually. Because recovery from the surgery – as with many other kinds of invasive medical procedures – can be painful and uncomfortable, doctors may end up prescribing medications to treat the pain. But post-surgical pain can be managed with other medications – particularly with non-opioid ones that put patients at much lower risk of long-term use and eventually dependency.
One study, led by Brigham and Women’s Hospital along with the Harvard Medical School, found that roughly 85% of women who are prescribed opioids fill their scripts after leaving the hospital. And on average, each new mother had about 15 pills remaining in her prescription after she took as many as she required for pain. And here’s where a really concerning and interesting finding came about: the researchers also found that the more pills mothers were prescribed, the more they were likely to take, regardless of their pain levels. In other words, when doctors provide too large of a prescription, the study found that patients – even ones who don’t need to – are more likely to take medications.
Another one of the studies found that out of the 179 C-section patients they surveyed, 165 were prescribed opioids. Only 7 women threw remaining medications away; the rest stored the leftovers in medicine cabinets. This is extremely worrisome because data shows that many people who use opioids without prescriptions acquire them in unlocked medicine cabinets of friends or family members.
New mothers are particularly vulnerable to being overprescribed opioids, as doctors may want to give them larger prescriptions to avoid requiring them to come in for yet another appointment. To combat this type of overprescribing, the third study found an interesting new technique that could cut opioid use in C-section patients as much as 50%.
After surgery, doctors met with patients to discuss pain management, the risks and advantages of opioid and non-opioid medications and how to safely get rid of any leftover pills. From there, patients were asked to choose how many 5-milligram tablets to receive when discharged – they could pick up to 40, as per the hospital’s prescription protocol. The majority of patients chose to receive 20 pills and had 4 remaining on average. The findings indicate that involving new mothers directly in the decision-making could largely inhibit not only the size of prescriptions, but also the likelihood of them becoming dependent, unsafely storing them or misusing them.
With our country facing an epidemic of opioid abuse and overdose deaths, it is imperative that doctors limit the amount of prescriptions they write as well as who they prescribe it to and for what reasons. It is also important to remember that a patient can always discuss medications – as well as what the alternatives may be– with their doctors directly. Some common signs of opioid misuse may include:
- Nausea, vomiting;
- Analgesia (feeling no pain);
- Itching or flushed skin;
- Small pupils, and:
If you are experiencing any of the above symptoms, please call 9-1-1 right away. If you have been prescribed opioids after having a C-section and have questions or concerns, please consult with your medical provider
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