Regulating Opioid Usage
February 23, 2018
A recent report published in the Annals of Internal Medicine found that as many as one-third of all American adults were prescribed opioids in 2015. However, a National Public Radio (NPR) investigation found that few doctors instruct their patients on how to safely taper off them. With the consequences of opioid abuse ranging from dangerous to deadly, it’s necessary to regulate opioid prescriptions and ensure that doctors prioritize the health and safety of their patients.
Opioids are a class of drugs that include morphine, codeine, heroin and fentanyl – as well as others. The National Institute on Drug Abuse – also known as NIDA – reports that opioids are highly addictive drugs that not only carry the risk for dependence, but also for overdose and death. Although some overdoses are treatable if they are caught in time, it’s important to know what signs to watch out for.
Even though there may be a place and a time for pain medications, studies show that doctors tend to prescribe too many pills and for too long of a time period. A study in the Journal of the American Medical Association (JAMA) found that anywhere from 67% to 92% of patients have pain medications left over after having routine surgical procedures. While part of the problem may be that different patients require different levels of pain management care, the bigger problem may be that there are no comprehensive guidelines in place for doctors to reference.
The only existing guidelines for prescribing opioid painkillers are from the Centers for Disease Control and Prevention (CDC), and they only apply to patients who are being treated for chronic pain. The guidelines don’t take into account the millions of others who are prescribed opioid medications after surgical procedures as well as for a range of medical conditions. It’s clear that the existing guidelines simply aren’t enough, and fail to offer comprehensive protection to patients. It is critical to create new guidelines and regulations that direct doctors on how to safely prescribe to patients – whether it means for a variety of applications or restricting which medical situations warrant opioid prescriptions.
Another major issue is that there are no general standards for how to safely taper, or wean, patients off opioids. People can experience a range of withdrawal symptoms when they stop taking their prescription, so it’s important to be supervised by a doctor who can assess and treat the symptoms. The CDC states that doctors should provide a range of services when tapering chronic pain patients off opioids, like slowly decreasing medication dosages, coordinating with treatment specialists and securing substance abuse counseling if necessary. Regardless of whether a patient is prescribed the medication for chronic pain or because he or she just had surgery, it’s crucial that there’s a plan in place to avoid abuse, overdose and death.
Additional reports indicate that some doctors overprescribe opioids to avoid getting “dissatisfied” ratings on patient surveys. Patient satisfaction ratings are closely linked to financial earnings and reputation – the lower the score a doctor gets on how effective he or she was at helping patients manage pain, the less likelihood there is of a return visit in the future. The same goes for treatment that patients receive in a hospital setting; if they feel their pain wasn’t managed by their care team correctly they are more likely to seek treatment elsewhere the next time.
The opioid epidemic not only affects those who are addicted to narcotic painkillers, but also their loved ones and friends. Hospitals that fail to implement reasonable and safe standards for how doctors should prescribe opioids directly put peoples’ lives at risk – but first these reasonable and safe standards need to exist. With all the information out there, it’s obvious that several serious changes need to be made; too many people have died from drug overdoses and sadly the numbers keep going up. Anyone who is prescribed opioids should talk with their doctor and discuss the dangers and benefits of their medication(s), as well talking about how to safely taper off the drug(s) when the time is right.
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