Pain Killer Protocol
It’s only been 21 years since the introduction of OxyContin started what we now refer to as the “opioid epidemic,” yet the number of deaths from drug overdoses in 2016 outnumbered the number of American deaths in the Vietnam War. Opioids are responsible for three-quarters of all drug overdoses, and as doctors continue to use them to manage patients’ pain, the deaths associated with opioid overdoses will only continue to increase.
In 2016, these high overdose rates led the Centers for Disease Control and Prevention (CDC) to introduce guidelines for prescribing opioids for chronic pain. Although many doctors recognize the necessity for control to reduce addiction and dependency rates, how well do they actually follow the guidelines? We surveyed over 1,000 people who’ve been prescribed opioids within the past five years to find out. Continue reading to learn more.
Explaining the Epidemic
The main goal of the CDC’s guidelines is to improve communication between providers and patients regarding the risks and benefits of opioid use as a treatment for chronic pain. One of the main ways this can affect opioid use is with the providers discussing alternative therapies with patients.
While most doctors thoroughly explained the proper uses of prescription opioids, 30 percent didn’t mention the availability of non-opioid options for pain management. Being quick to prescribe opioids without mentioning alternate therapies can fuel the severity of the epidemic, leading patients to believe opioids are their only options when non-pharmacologic therapy and non-opioid pharmacologic therapy are the preferred methods for chronic pain management.
Following the Guidelines
While the CDC guidelines were put into place to prescribe for chronic pain, opioids are also used to treat acute pain. So how do doctors approach the two differently? It turns out that physicians prescribing opioids for chronic pain were more likely to follow the guidelines according to their patients.
Compliance with the guidelines also varied by reason for the prescription. Establishing treatment goals for managing pain was the guideline patients reported their physicians followed the most across all reasons. People receiving opioids for nerve pain or muscle pain were the most likely to report their physicians following the guidelines established by the CDC.
Evidence of Overprescribing
When providers decide prescription opioids may be the best ways to manage pain, there’s a fine line between adequate dosing and overprescribing. Patients prescribed opioids for surgical procedures may have been the most likely to report their doctors following the guidelines, but a recent study found doctors still overprescribe opioids after surgery.
In fact, 19 percent of people prescribed opioids following a non-oral surgical procedure said a smaller dosage would have been sufficient to treat their pain. Additionally, 22 percent of respondents treated for acute pain and 13 percent of participants treated for chronic pain agreed a smaller dose would have sufficed as well.
Take the Pain
It’s widely believed women tolerate pain better than men. After all, childbirth is one of the most painful things the human body can go through. But this isn’t always the case. While men and women share a very similar tolerance to chronic pain, men are more tolerant when it comes to acute pain. However, our study found contradicting results.
On average, men said it was appropriate for opioids to be prescribed when their pain hit a level of 6.6, while women said it wasn’t appropriate until their pain reached 7.7. Our male respondents also reported receiving their last opioid prescription after experiencing a pain level of 7.0, compared to women receiving their prescription after a pain level of 7.3.
Drug Disposal
The dangers of opioid use are clear, but it may be surprising to many that leftover pills from opioid prescriptions also pose a risk. Unused pills leave the door open for theft, misuse, and accidental overdose. With 70 percent of respondents reporting having leftover opioid medication, what are they doing with their unused pills?
Thirty-five percent of those with leftovers kept the dosages but had yet to use them, while 12 percent dipped into their leftover stash for non-prescribed purposes. Thirty-two percent disposed of their leftover pills at home or in the trash and at an authorized drug collection site.
For those who are unfamiliar, the DEA set up the National Prescription Drug Take Back Day so people can anonymously and safely dispose of their unused medications. While the national day also provides events to educate the public on drug safety, drug take-back sites are available year-round for residents to clean out their medicine cabinets. You can easily find a location near you here.
To Take or Not to Take
Prescription medications are so common, most people don’t think twice before filling one at the pharmacy. We tend to trust doctors to make the right decisions when it comes to our health, which is likely why 54 percent of respondents were comfortable using prescription opioids to manage their pain. However, 31 percent of people reported being uncomfortable with prescription opioid use.
Baby boomers and millennials are the most at risk when it comes to the opioid epidemic. While millennials are abusing painkillers more than any other generation, baby boomers have had heightened death rates due to prescription opioid overdoses. The heightened death rates could be the reason why 39 percent of baby boomers felt uncomfortable with prescription use. While only 29 percent of millennials felt the same, one thing is for sure – physicians failing to follow guidelines when prescribing opioids leaves patients feeling more uncomfortable with using these medications.
Education Can End the Epidemic
There are many factors to the opioid epidemic – lack of education, overprescribing, and illicit use all have a significant impact on the number of deaths caused by accidental opioid overdoses. The CDC’s guidelines are a step in the right direction, but it is up to physicians to follow suit.
However, you should also familiarize yourself with the dangers of opioid use, when opioids are truly necessary, and whether alternative treatments can help you manage your pain. Finding the proper information doesn’t have to be a hassle, either. At DrugAbuse.com, we have all the information you need to educate yourself on addiction and treatment. From prevention to detox, we can help you take your health into your own hands.
Methodology
We collected responses from 1,011 people prescribed an opioid-class prescription painkiller medication within the past five years at the time of our survey. Fifty-five percent of participants were women, 45 percent were men, and less than 1 percent identified as a gender not listed in our survey. Participants ranged in age from 19 to 76 with a mean of 36 and a standard deviation of 11.8.
The data we are presenting rely on self-reporting. No statistical testing was performed, so the claims listed above are based on means alone. As such, this content is purely exploratory.
Sources
- https://www.nytimes.com/2018/05/29/health/purdue-opioids-oxycontin.html
- https://www.cbsnews.com/news/opioids-drug-overdose-killed-more-americans-last-year-than-the-vietnam-war/
- https://www.nbcnews.com/think/opinion/fix-opioid-crisis-doctors-me-may-have-let-patients-be-ncna836141
- https://www.cdc.gov/drugoverdose/pdf/Guidelines_Factsheet-a.pdf
- https://www.webmd.com/drug-medication/news/20180419/opioids-still-overprescribed-after-surgery-study#1
- https://www.drugabuse.gov/publications/research-reports/substance-use-in-women/sex-gender-differences-in-substance-use
- https://abcnews.go.com/Technology/story?id=97662&page=1
- https://takebackday.dea.gov
- https://apps.deadiversion.usdoj.gov/pubdispsearch/spring/main?execution=e1s1
- https://www.cdc.gov/media/dpk/prescription-drug-overdose/opioid-prescription-guidelines/dpk-opioid-prescription-guidelines.html
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- https://drugabuse.com/featured/drug-and-alcohol-abuse-across-generations/
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