Scioto County Health Commissioner Dr. Aaron Adams says he agrees with the latest Centers for Disease Control guidelines for prescribing opioids for chronic pain, and takes that idea a step further.
“I think guidelines are a good starting place,” Adams said. “I think we need to get the providers to start backpedling from all of the overprescribing we have dealt with over the years.”
As part of the U.S. government’s urgent response to the epidemic of overdose deaths, the CDC has issued new recommendations for prescribing opioid medications for chronic pain, excluding cancer, palliative, and end-of-life care. The CDC Guideline for Prescribing Opioids for Chronic Pain, United States, 2016 will help primary care providers ensure the safest and most effective treatment for their patients.
The United States is currently experiencing an epidemic of prescription opioid overdose. Increased prescribing and sales of opioids—a quadrupling since 1999— helped create and fuel the epidemic. More than 40 Americans die each day from prescription opioid overdoses.
“We’ve seen so many deaths, so many overdoses, still from prescription drugs, not just the heroin,” Adams said. “We’ve got to develop a culture of prescribers that don’t prescribe opiates, particularly the hydrocodone, the oxycodone for chronic pain. We’ve got to get away from that. We use those for acute pain and try in certain situations that it’s required like post-operative care, some type of serious injury, or consider some type of lesser pain medications like the non-steroidal anti-infalatory derivatives, physical therapy, Tylenol (Acetaminophen), massage, other modalities to avoid the possibilities of addiction.”
Adams says what is being seen now is doctors who are prescribers are stepping back and taking a different look at what they are prescribing and what they are prescribing them for.
“I always want to give a message that people understand, it’s real easy to start drifting away into your own world, and you don’t give a good message that is clear that people understand,” Adams said. “I always tell myself we’ve got to make sure that people there are people that really need these medications that don’t really understand the scope of the problem or need medications other than the opiates, they ought to be involved in the decision-making.”
Adams says it’s a good sign that the medical profession is starting to get an education culture and more awareness of the problem.
Among the 12 recommendations in the guideline, three principles are key to improving patient care. They are that non-opioid therapy is preferred for chronic pain outside of active cancer, palliative, and end-of-life care; when opioids are used, the lowest possible effective dosage should be prescribed to reduce risks of opioid use disorder and overdose, and providers should always exercise caution when prescribing opioids and monitor all patients closely.