Tuesday, February 26, 2013

No Pain for 30 Days: How About Another Bottle of Pills?

"Researchers from the National Institute on Drug Abuse (NIDA), a component of the National Institutes of Health, found that more than half of patients who received an opioid prescription in 2009 had filled another opioid prescription within the previous 30 days."

The extensive research sample included 79.5 million prescriptions dispensed in the United States during 2009, which represent almost 40 percent of all the opioid prescriptions filled nationwide.

This analysis comes on the heels of a nearly 20 year increase in the use of prescription painkillers. From 1991 to 2009, prescriptions for opioid analgesics increased almost threefold, to over 200 million. According to the Drug Abuse Warning Network system, which monitors drug-related emergency department visits and drug-related deaths, emergency room visits related to the nonmedical use of pharmaceutical opioids has doubled between 2005 and 2009.

What Else Did This Extensive Study Find? 

* Leftover pills in family medicine cabinets increase opportunities for abuse, as well as a host of serious medical consequences, including addiction.

* Most abusers report getting these medications from friends and relatives who had been prescribed opioids, or they (the abusers) are abusing their own medications.

* Nearly 12 percent of opioids prescribed were to young people aged
10-29. Most of these were hydrocodone- and oxycodone-containing products, like Vicodin and Oxycontin.

* Dentists were the main prescribers for youth aged 10-19 years old.

* Nearly 46 percent of opioid prescriptions were given to patients between ages 40 and 59, and most of those were from primary care providers.

("Analysis of Opioid Prescription Practices Finds Areas of Concern," National Institutes
of Health News, The U.S. Department of Health and Human Services, April 5 2011)

According to the Centers for Disease Control and Prevention, prescription opioid overdose is now the second leading cause of accidental death in the United States, killing more people than heroin and cocaine combined. They also state that this is compelling evidence for the need to develop smart strategies to curtail abuse of opioid analgesics, without jeopardizing pain treatment.

NIDA Director Nora D. Volkow, M.D. says, "As a nation, it is important that we all become better informed about effective pain management and the risks of abusing prescription painkillers."

My Take

Volkow says "we all" must be better informed. The definition of "all" obviously includes practicing doctors who have received little formal training in pain management. Everyone is aware of the problems created by pill mills and rogue doctors who illegally prescribe opioids. Yet, we must also understand that all doctors in good standing should be required to take mandatory training before allowing them to prescribe opioids.

As they prescribe opiates, most dentists and primary care providers may not intentionally contribute to the staggering numbers of those lost to drug abuse, but, more than anyone else, they must be fully educated concerning the dangers of these substances and extremely sensitive to proper management of them. In short, we, the public, and the FDA must insist on mandatory training immediately. And, for evident reasons, the training cannot be funded and provided by Big Pharma or anyone else with possible bias. 

In America, we have too many medical professionals who are pulling their pained patients into a deadly fire as they continue to over-prescribe painkillers:

* Some of them are guilty of being greedy criminals who could care less about who swallows what medication;

* Some of them are guilty of being careless, inefficient managers of potentially harmful pain relief; and

* Some of them are ignorant, mindless accessories to all the horrors of drug addiction.  

"There is both overprescribing and underprescribing," says Director Volkow, who notes that, for instance, many dentists give opioids like Percoset too freely to teenagers after surgical procedures; in contrast, "you have individuals with very severe pain who are not given opioids or who are given doses that are [too low to treat the pain], and that in and of itself can put them at risk."

I hope you can understand in this Prescription Nation why we must insist that all of our medical professionals who write prescriptions for pain relief be sent back to the classroom -- a classroom manned by unbiased instructors armed with new, independent, research-based materials.

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