Pain and Opioid Epidemic

Pain and Opioid Epidemic

by | Oct 10, 2017 | Blog, Locum Tenens, Opioid Crisis, Opioid Epidemic | 0 comments

The Opioid Epidemic in the United States

In 2015, the number of Americans killed by guns was exceeded by those killed by heroin overdose. [5] According to the Drug Enforcement Administration, overdose deaths from drugs including pain killers and heroin have now become the “leading cause of injury death in the United States.” [4]

 

“Pill Mills” and Cartels

This phenomenon can be attributed, in part, to prescriptions made in haste by reckless physicians. Clinic after clinic has been observed and often prosecuted for excessively prescribing painkillers to patients. Though law enforcement efforts have succeeded in lessening their presence, “pill mills” still exist across the country. Established for the purpose of distributing painkillers for illicit use, these pill mills have been a highly significant contributor to the ongoing epidemic. [4]

While physicians at more reputable clinics often cut patients off when they suspect painkiller abuse, this approach can often result in undesired consequences. Drug abusers, and even legitimately sick people, find themselves forced to cope with withdrawal symptoms. Withdrawal from opiates can be intensely painful without a controlled drawdown, leading these people to immediately seek relief. They can find relief in the alternative to prescription painkillers – heroin. [9]

Made plentiful by drug traffickers, cartels and other criminal organizations, heroin use has steadily increased since 2007. [4] As it is far cheaper than painkillers and no prescriptions are required, heroin is fast becoming the drug of choice for those who would previously only use pills. [9] A synthetic opiate known as fentanyl, which is even more powerful than heroin, has also been observed making waves in the nation. Drug overdose deaths resulting from this toxic substance have skyrocketed since 2014. [8]

The breadth of the issue can be observed most clearly with one startling statistic. Drug overdoses have increased to the point that they are a significant factor in the recent reversal of the longstanding upward trend in American life expectancy. This has not occurred in more than two decades. [2] Furthermore, emergency care units have seen sharp rises in cases regarding overdose victims. [3] With such sharp increases, medical facilities are being strained, and calls have been made for action to be taken to reverse the trend. The economic costs alone are staggering: Health and social costs are estimated to be $55 billion with an additional $20 billion in medical care. [6]

Government Response

In response to the ongoing opioid epidemic, the federal government plans to contribute increased funds to the CDC and other health agencies. The hope is that these agencies can help reverse the disturbing trend of abuse and overdoses by implementing stricter regulation of prescription drugs. [6] Federal policies also aim to ramp up law enforcement efforts, both on the federal and local levels, to fight drug trafficking organizations. [1]

 

References

  1. https://www.washingtonpost.com/news/wonk/wp/2017/07/31/white-house-opioid-commission-to-trump-declare-a-national-emergency-on-drug-overdoses/?utm_term=.b2dfbd3c46b5

 

  1. https://www.cbsnews.com/news/drug-overdose-deaths-heroin-opioid-prescription-painkillers-more-than-guns/

 

  1. http://www.medscape.com/viewarticle/885013

 

  1. https://www.dea.gov/docs/2015%20NDTA%20Report.pdf

 

  1. https://www.nytimes.com/2017/01/06/us/opioid-crisis-epidemic.html

 

  1. https://www.hhs.gov/sites/default/files/Factsheet-opioids-061516.pdf

 

  1. http://hightimes.com/news/jeff-sessions-drug-overdoses-are-top-lethal-issue-in-the-u-s/

 

  1. http://www.cincinnati.com/story/news/2017/08/30/ohio-drug-overdose-deaths-more-than-double-thanks-fentanyl/618778001/

 

  1. http://www.cnn.com/2014/08/29/health/gupta-unintended-consequences/index.html
How Doctors Are Managing The Opioid Epidemic

How Doctors Are Managing The Opioid Epidemic

by | May 9, 2017 | Blog, Opioid Crisis | 0 comments

Overdose and deaths due to opioid use are rising at a fast rate in the United States. The medical profession is now taking steps to curb opioid usage by trying different pain management techniques and teaching doctors about the dangers of prescribing opioids.

How Doctors Are Managing the Opioid Epidemic

The Center for Disease Control has compiled statistics that show the death toll in 2016 for opioid and opiate-based medication use in the United States was over 30,000 people. This is 2.8 times more than the number of deaths due to opioid and opiate use in 2002. The alarming increase has changed the way the medical profession looks at opioids and how they are used. Here are three of the most significant changes the medical profession has made when prescribing opioids to reduce the number of people becoming addicted to opioid-based drugs.

New Pain Management Guidelines

The opioid epidemic affecting the country has caused the American College of Physicians to update and change its pain management guidelines. The new guidelines state that prescribing opioids for chronic pain should be done as a last resort when other pain management techniques have failed.

Doctors should first incorporate non-drug and non-invasive therapies into the pain management program of a patient. Therapies recommended to be done before using pain medications include things like chiropractic spinal manipulation techniques, acupuncture, massage and heat therapy.

New Prescription Guidelines

The Center for Disease Control has also issued new guidelines on how and when doctors should prescribe opioids for people with chronic pain. The guidelines promote the use of non-invasive and non-drug therapies as well as dictate dose rates and usage.

The Joint Commission that accredits thousands of health care centers, clinics and hospitals in the United States has also addressed the use of non-invasive and non-drug techniques to treat chronic pain. The Joint Commission now recommends that physicians use alternative treatments like chiropractic care and acupuncture for patients suffering from severe chronic pain.

Physician Training on Opioids

One of the most cited reasons for the opioid epidemic is that doctors prescribing the medications are often under-trained on the effects of the opioids on patients. For instance, doctors in Arizona do not have to be educated in opioid-based medications and the effects of their usage on patients. A recent survey of doctors showed that 72 percent who were surveyed had an insufficient knowledge of opioids and their effects. This lack of knowledge is about to change.

Public Health Law agencies across the country are undergoing reviews of the training doctors have received in opioid-based medications and are developing continuing education courses that the doctors will be required to take to maintain their license to practice. In time, as more and more doctors take the advanced training, the hope is that they will be more knowledgeable as to how they prescribe opioid-based medications to avoid future addictions and overdoses.

References:

[1] https://www.cdc.gov/drugoverdose/

[2] http://annals.org/aim/article/2603228/noninvasive-treatments-acute-subacute-chronic-low-back-pain-clinical-practice

[3] https://www.cdc.gov/drugoverdose/prescribing/guideline.html

[4] http://www.jointcommission.org/assets/1/18/Clarification_of_the_Pain_Management__Standard.pdf

[5] https://cronkitenews.azpbs.org/hookedrx/doctor-training-pain-management-opioids/