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Too many of us taking too many opioid painkillers
Thanks to our location near Colorado, the subject of legalized marijuana for recreational or medical use is the most common topic of drug-related conversation in Southwest Nebraska.
But a much more potent class of chemicals, in the form of opium-derived legal and illegal drugs, is worthy of discussion.
Recent news reports have pointed out the rise in heroin addiction in all segments of society, and President Obama is throwing the spotlight on that issue as well as prescription painkillers during a visit to Atlanta today.
There is reason to be concerned. Drug overdoses have surpassed car crashes as the leading cause of preventable death for American adults, with prescription opioids contributing to more deaths than heroin and cocaine combined.
Doctors prescribe enough opioids to give every American a bottle of pills, according to the National Safety Council.
A record number of Americans died from drug overdoses in 2014, highest in West Virginia, New Mexico, New Hampshire, Kentucky and Ohio.
The administration is announcing $11 million in grants for up to 11 states for medication-assisted treatment and another $11 million for states to buy and distribute an overdose drug. Regulators also want to make it possible for qualified physicians to prescribe the treatment drug to more people.
But there's no shortage of problem painkillers nor doctors to prescribe them, according to a survey by the NSC, which wants to steer physicians and patients to safer alternatives.
The NSC found that 99 percent of doctors are prescribing opioid medicines for longer than the three-day period recommended by the Centers for Disease Control and Prevention.
Twenty-three percent of doctors prescribe at least a month's worth of opioids, and 74 percent incorrectly believe morphine and oxycodone, both opioids are the most effective ways to treat pain, according to the NSC. NSC research, however, shows that over-the-counter pain relievers such as ibuprofen and acetaminophen are the most effective relief for acute pain.
Virtually all doctors surveyed said they had seen a pill-seeking patient or evidence of opioid abuse, but only 38 percent refer those patients to treatment. Only 5 percent treat them for abuse themselves.
Despite new CDC guidelines calling for doctors to use the lowest possible effective dosage of opioids turn to non-opioid medications or non-pharmacologic therapies, opioids are being prescribed improperly.
The NSC found 71 percent of doctors prescribe opioids for chronic back pain and 55 percent for dental pain, neither of which is appropriate in most cases. Sixty-seven percent of doctors prescribe opioids because they think their patients want them, but 50 percent of patients said they were more likely to return to their doctor if he or she offered alternatives.
Eighty-four percent of doctors screen for prior opioid abuse, but only 32 percent screen for family history of addiction, a strong indicator of potential abuse.
The U.S. Food and Drug Administration said it would require strong warnings on short-acting opioid painkillers that Will bring information about addiction and abuse in line with long-acting pills. Short-acting opioids account for 90 percent of prescriptions, 87 branded and 141 generics from combination acetaminophen-opioid pills to intravenous formulations.
We should be grateful good medical care is readily available, and that includes effective pain relief. Patients and doctors, however, need to be careful they're not trading the symptom of pain for the disease of addiction.