Over-prescribing opioids: Where does this problem stem from?Prescription Drugs
By pH health care professionals
We’ve recently reported on the tremendous overuse of prescription painkiller drugs in this country. Almost everyone knows someone on Vicodin, Percocet, or Norco. Some patients have trouble getting off the drugs, and part of the problem is over-prescribing.
So, where is this over-prescribing coming from?
Doctors writing in JAMA Internal Medicine in December wanted to find out whether a few “pill mill” medical practices were to blame for so many overdoses and cases of addiction. Looking at Medicare data from 2013, they sought to confirm troubling data from the California Worker’s Compensation Survey, which found that 1 percent of prescribers (doctors, nurse practitioners and physician assistants) wrote one-third of controlled substance prescriptions in worker’s compensation cases. They looked at prescriptions for hydrocodone, oxycodone, fentanyl, morphine, methadone, hydromorphone, oxymorphone, meperidine, codeine, opium and levorphanol.
But the doctors found the opposite. While orthopedic surgery, rehabilitation and pain management accounted for many prescriptions, the prescribers most likely to write the prescriptions overall were in family practice and internal medicine. Nurse practitioners wrote 2 million more prescriptions than pain management doctors did.
How can your doctors be proactive?
Primary care doctors can do a lot to avoid prescribing so many pain drugs. They can sign a contract with the patient in which the patient agrees not to sell their drugs or ask for replacement prescriptions. They can check databases and remove patients who “cheat” and get extra prescriptions by doctor shopping. They can prescribe non-opiate, non-opioid medicines (like gabapentin), which are less likely to cause addiction and overdose. They can refer patients to pain management doctors, who have special training in fine-tuning medications and can do procedures to numb pain, like a nerve block.
How can you, as a patient, be proactive?
- Ask about options. If your doctor prescribes you painkillers, ask what alternative you have for when your pain is not that bad. Opioids and opiates fool your brain into thinking there is no pain, and compromise your ability to drive and think clearly. Since your daily function is at stake, having a non-sedating alternative handy is ideal.
- Don’t mix and match without permission. Do not combine your medications unless you are told it is okay to do so. Some doctors and dentists will alternate these medications with high-dose ibuprofen in order to break up the amount of time that the brain and liver have to deal with processing the Norco or Percocet.
- Minimize side effects. Some side effects may be the result of nutrient deficiencies, caused or worsened by the drug. This doesn’t mean you should avoid taking necessary prescription drugs; rather, you should be proactive in addressing any deficiencies and preventing levels from getting to low. Nutrition testing, and asking a patient advocate (855-PHLABS1) about drug and supplement interactions, are some proactive steps you can take.
Enjoy Your Healthy Life!
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