Opioid Guidelines

The Pain of Pills: Ending America's Epidemic

Opioid prescriptions are so much of a problem that the CDC, or Centers for Disease Control and Prevention, is sounding off. They recently released new guidelines in the hopes of curtailing the prescription drug problem in America.

How prevalent are opioids in the US? According to a CDC report, enough opioid pain relievers were sold in 2010 to “medicate every adult in the United States with the equivalent of 5mg of hydrocodone every 4 hours for 1 month.”

The leading cause of death in 2012 among those 25 to 64 years old was from drug overdose. More so than from motor vehicle accidents. The number of deaths from opioids doubled from 1999 to 2013.

How did we get to this epidemic?

Prescription pills weren't always in fashion:

Around the 1990s, the attitude toward prescription drugs got a marketing makeover thanks to pressure from patients and pharmaceutical makers. Where it had once been a last resort for the most severe pain, opioids quickly became a first line of treatment for even minor injuries.

A once conservatively used medical intervention suddenly became a pharm-frenzy of overuse. OxyContin, Vicodin and Percocet became household names.

Opioids can have a place for severe pain when other treatments have been tried and failed to provide adequate relief. Start with things like anti-inflammatory medicines, physical therapy and minimally invasive injections. However, too often opioids were being prescribed for too many patients with too little effort on the first steps of treatment. It was just too easy!

Prescription pills were soon the trend:

As prescription pad misuse grew, patients learned to request medications by name. If the patient didn't finish the drugs, another family member or teenager in the household might. By 2012, there were 259 million opioid prescriptions.

Ready-access to opioids led to widespread use. Too easy access was bound to lead to abuse. As physicians tried to put the cat back in the bag there were a large number of those dependent on the medication. A black market for the drugs developed.

The prescription drug epidemic is finally attracting attention:

For years, the addicted were found mostly in inner cities and rural areas. Related problems among the rich and famous were likely hard to relate to. Experts seem to agree that when the problem spread to middle-class communities it began to capture the public's attention. A spike in overdoses was a huge wake-up call to the consequences of opioid abuse in our country.

The Centers for Disease Control is sounding off:

Finally, a federal agency is issuing new guidelines for prescribing opioids. The CDC guidelines are specific suggestions for primary care clinicians for prescribing to adults in chronic pain lasting more than three months or beyond the normal time needed for tissue healing. The recommendations do not cover cancer or end-of-life care. The thought is that stopping over-prescribing of opioid for non-cancer pain will curb abuse and addiction.

Of course merely stopping opioids is not enough. Pushing for better access to alternatives to opioids is what must come next. Good alternatives to opioids for pain management include physical therapies and acupuncture. They include non-abuse medications that target inflammation, neurogenic pain, depression and sleep.

Non-surgical pain blockers can be a part of the equation as well including radiofrequency or spinal cord stimulators for neck and low back pain. Even methods like meditation, cognitive-behavior therapy and breathing techniques can help with long-term pain control.

The Bottom Line:

The CDC guidelines are a much-needed addition to the public health conversation on drug addiction. But they are only a part of reducing addiction and overdose deaths. To really reduce the numbers and bring an improved quality of life to ailing Americans, we need a collaborative approach that includes state-of-the art, alternative care.

Dr. Eric Lonseth advises you build a relationship with a pain management provider before allowing a physician to prescribe painkiller medication. For more information, contact Lonseth Interventional Pain Centers at 504.327.5857