Opioid overdoses on the rise5 years ago | Prescription Drugs
By pH health care professionals
The U.S. is experiencing an epidemic in drug overdose deaths, the CDC says, and misuse of opioid painkillers are a big part of the problem. Since 2000, overdose deaths from opioids have risen 200 percent. In 2014, there were approximately one and a half times more drug overdose deaths than deaths from car crashes in the U.S.
It seems everyone is taking opioids
Prescription opioid sales in the U.S. have increased by 300 percent since 1999, the CDC says, but there hasn’t been a change in the amount of pain Americans report. In 2012, the CDC reports that health care providers wrote 259 million prescriptions for opioid pain relievers, which is enough for every American adult to have a bottle of pills. An estimated 20 percent of patients with non-cancer pain symptoms or pain-related diagnoses receive an opioid prescription.
These pain relievers can serve in important purpose in helping patients manage pain, but when misused, they can be dangerous. Take a few minutes to educate yourself about opioid medications so you can be proactive and make sure you understand how to use them safely.
So what exactly are opioid medications?
Opioids are prescription drugs used for relieving moderate to severe pain. According to the National Institutes of Health, they “reduce the intensity of pain signals reaching the brain and affect those brain areas controlling emotion, which diminishes the effects of a painful stimulus.” A few examples of when they are prescribed include cancer, rheumatoid arthritis, after surgery or a trauma, back pain and fibromyalgia.
Hydrocodone (e.g., Vicodin), oxycodone (e.g., OxyContin, Percocet), morphine (e.g., Kadian, Avinza), and codeine are common opioid medications.
What should you know about opioid dependence, addiction and overdose?
Over time, your body can develop a tolerance to the opioid medication, where you have to take more of it to achieve the same effect. You can also become physically dependent on it, in which case you would experience withdrawal symptoms if you reduced the dose or stopped taking it. In some cases, patients become addicted to it, which would be characterized by impaired control over drug use, compulsive use, continued use despite harm, and craving.
Some research shows around 25 percent of opioid painkillers prescribed for chronic pain are misused, and that opioid addiction may be as high as 10 percent of prescriptions. Opioids are most dangerous and addictive when taken to get a “high,” such as crushing pills and then snorting or injecting the powder, or combining the pills with alcohol or other drugs.
The National Institute of Drug Abuse (part of the NIH) says unintentional overdose deaths from prescription pain relievers has more than quadrupled since 1999. Some of the root causes, the institute says, include the drastic increases in the number of prescriptions written and dispensed, greater social acceptance of using the meds for various purposes, and the aggressive advertising by the pharm companies.
How can you be proactive?
According to the CDC, primary care providers say they receive insufficient training in prescribing opioid pain relievers. Doctors should follow research-based guidelines to determine when to initiate or continue opioids for chronic pain outside end-of-life care; determine most appropriate selection, dosage, duration and follow-up; and assess the risk and address harms of opioid use. Doctors should also review the patient’s history of controlled substance prescriptions.
As a patient, you should ask about the benefits and side effects, and ensure instructions for recommended dosage and duration are clear and written down. It is also very important that you disclose any other prescriptions or herbal supplements you are taking to your doctor, to avoid dangerous combinations. As a patient, you should inform your doctor when you don’t feel the drug is doing enough (don’t increase your dose on your own). And you should also monitor and track how often you are taking the drug, how you feel, and any side effects and any concerns. One way to do this is with a “pain diary,” where you write down your daily average pain score over a period of time (1-2 weeks, for example) so the doctor can determine the effectiveness of the drug and its necessity.
In some situations, such as when you are worried you are not getting appropriate care, you may need a patient advocate to work on your behalf. Our advocates are doctors who can review your medical history, give a second opinion, and provide recommendations to help you reclaim your healthy life. They also check for things like nutrient depletion (did you know many prescription drugs deplete essential vitamins and minerals from your body?), which many doctors do not check.
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