Following a rise in lethal overdoses caused by heroin and prescription opioid drugs, the Centers for Disease Control and Prevention (CDC) released recommendations in late 2015 urging physicians to use alternative methods to tackle chronic pain. The government agency is recommending the use of non-opioid analgesics, as well as physical therapy in lieu of opioid painkillers and drugs.
The CDC recommendations stress that where opioids such as Percocet and OxyContin are necessary, short-term prescriptions of short-acting versions given in the lowest possible doses should be the norm. These draft directives suggest that doctors should prescribe opioid painkillers only after getting and analyzing urine test results from patients. Patients who continue on opioid prescriptions should also undertake additional urine tests at least once every year to help ensure that they are not taking illegal drugs and are not taking other opioid drugs without their prescribing physician’s knowledge.
Steep Rise in Overdose-Related Deaths
These recommendations come in the wake of a steep rise in overdose-related deaths that hit an all-time high of nearly half a million Americans between 2000 and 2015. In fact, the death count from prescription opioid drugs and the illegal street drug heroin rose by 14% each year during this period. Some 23,500 Americans died from overdoses on opioid drugs in 2000 compared to 47,000 who lost their lives for the same reason in 2014. As a result, the CDC has stressed to physicians that prescribing opioid drugs is a decision that should be preceded with strong familiarity with the patient and serious consideration of potential short and long-term effects.
What’s Driving the Epidemic?
Why are so many people abusing prescription opioid drugs or using illegal opioids like heroin? According to the World Health Organization (WHO), the escalating number of opioid overdoses has increased over recent years partially due to the frequency that physicians prescribe opioid drugs to manage their chronic pain.
There are also a vast number of people who start by abusing prescriptions opioids, and then eventually turn to heroin because it is cheaper and easier to get. In fact, a 60 mg prescription opioid pill can cost someone who is uninsured about $60, but the equivalent amount of heroin can be purchased for about $6.
Dr. Jason Jerry, an addiction specialist at the Cleveland Clinic’s Alcohol and Drug Recovery Center, says about half of the about 200 heroin addicts he sees at his clinic every month started on opioid prescription painkillers. He says:
“Often it’s a legitimate prescription, but the next thing they know, they’re obtaining the pills illicitly. So people eventually say, ‘why am I paying $1 per milligram for oxy when for a tenth of the price I can get an equivalent dose of heroin?”
CDC Recommendations to Manage the Overdose Epidemic on Opioid Drugs
The CDC offers four recommendations that they hope will help manage the overdose epidemic:
- Enhanced physician education will help limit physicians prescribing opioid drugs when non-pharmacologic pain management therapies can be used. They can also prescribe the short-acting opioids rather than the long-acting, extended release opioids when a patient begins opioid therapy. Additionally, physicians will be prompted to openly talk to patients about the risks and benefits of opioid treatment, as well as have them follow up one to four weeks after initial prescription.
- The government will increase access to disorder treatment of evidence-based substance use. Such measures will include medication-assisted treatment for patients suffering from disorders related to opioid use.
- The government also plans to increase access to Naloxone among patients suffering opioid use-related disorder, as this is an important drug that is able to reverse signs of opioid overdose.
- The government health agencies and facilities, law enforcement agencies, as well as coroners and medical examiners will work together to help improve detection of substance overdose and response so as to address what is clearly an emerging public health and safety threat.
These recommendations, however, are not binding. Moreover, physicians treating patients who suffer severe chronic pain stemming from diseases like late-stage cancer will be more apt to disregard them. Doctors offering end-of-life care too, can ignore the said recommendations.
With the new CDC guidelines, more physicians may begin monitoring their prescription habits more closely and recommending their chronic pain patients to try other routes to manage pain that do not include opioids, such as non-narcotics or alternative health treatments like acupuncture or massage therapy. While it’s not realistic to think that no one will become addicted to opiates when prescribed legitimately by physicians, with the medical providers following stricter guidelines, the number of addicts and overdoses may indeed decrease.
Dominica Applegate is dedicated to the art of self-discovery and creative expression with a passion for creative art. She’s got a deep-rooted passion for helping others heal emotional pain and trauma, as her own journey through love addiction has served as a catalyst for her own healing and beautiful transformation. Find out more at www.dominicaapplegate.com.