Doctors can do one simple thing to fight the opioid abuse epidemic

Insurance can take care of that.
Insurance can take care of that.
Image: AP Photo/Toby Talbot
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Each day, more than 40 people in the United States die from an overdose of painkillers.

On Tuesday (March 15), the Centers for Disease Control and Prevention (CDC) released final recommendations to doctors treating patients in pain with opioids, prescription drugs like Vicodin, OxyContin, and Percocet. And basically, it comes down to the fact that doctors shouldn’t prescribe them so often.

“The science of opioids for chronic pain is clear,” Tom Frieden, the director of the CDC, said in a teleconference yesterday. “For the vast majority of patients, the known, serious and all-too-often fatal risks far outweigh the unproven and transient benefits.”

American doctors prescribe a lot of opioids: In 2012, enough opiate prescriptions were written so that every adult in the country could have a bottle. They’re highly effective to mitigate pain, either from injuries like broken bones, surgery, or chronic conditions, because of their ability to bond with opioid receptors found naturally in our bodies. Our bodies even produce their own opiate-like chemicals in our brains like endorphins, which we feel can get from activities like exercise, eating, and even sex.

Yet prescription opiates are highly addictive and easily abused; in 2013, almost 2 million adults in the US were addicted to opioid painkillers; estimates from the same year suggest that about 628,000 people in the US are addicted to heroin. When they’re taken in doses at too high levels, they slow down or stop our breathing; between 1999 and 2014 opioid drugs killed 165,000.

The CDC’s recommendations suggest that doctors avoid prescribing long-term opioid pain killers, aside from patients receiving cancer treatment or end of life care. And if they have to prescribe opiates, they should use ones that work immediately (as opposed to slow-release drugs) for short period of time—a week or so at the most—at the lowest doses possible.

Frieden also recommended that patients ask about the risks of the drugs they receive, the likelihood they have of becoming addicted, and if there are alternative ways (pdf) of alleviating their pain, like physical and cognitive therapy. But he placed the burden on physicians: ”The prescription overdose epidemic is doctor-driven,” he said. “It can be reversed in part by doctors’ actions.”