On Tuesday, federal health officials called on American physicians to stop treating common ailments with highly addictive opioids, stating the nation’s prescription drug epidemic was a “doctor-driven” crisis.
The appeal was a part of the release of new guidelines by the Centers for Disease Control and Prevention that heavily encourage doctors to refrain from prescribing opiates for back problems, migraines, arthritis and other chronic pain conditions, which has been a routine practice over the last fifteen years. Some of the opiates mentioned include OxyContin, Percocet and Vicodin.
“For the vast majority of patients, the known serious and all-too-often-fatal risks far outweigh the unproven and transient benefits,” said Dr. Tom Frieden, CDC director. Nearly all the opiate painkillers physicians prescribe “are just as addictive as heroin,” he added.
Doctors are not required to follow the CDC guidelines, but Frieden said state agencies, private insurers and other groups might look to the recommendations in setting their own policies and guidelines. The agency stressed its severe doubts about the safety and effectiveness of painkillers to physicians with articles posted in the New England Journal of Medicine and the Journal of the American Medical Association detailing the new recommendations.
“We know of no other medication routinely used for a nonfatal condition that kills patients so frequently,” Frieden and and a co-author wrote in the New England Journal of Medicine. Some experts anticipated that even without new regulations, the CDC’s warning would have an immediate impact on how physicians dispense prescriptions.
“Doctors hold the CDC in high regard, and its recommendations are going to be taken seriously,” said Dr. Andrew Kolodny, executive director of Physicians for Responsible Opioid Prescribing. “For the first time, the federal government is communicating clearly that the widespread practice of treating common conditions with long-term opioids is inappropriate.”
Deadly Outcomes From Legal Drugs
In applauding the new recommendations, Health and Human Services Secretary Sylvia M. Burwell said she had witnessed firsthand the devastating impact of painkiller abuse in her home state West Virginia and described opiate deaths as “one of the most pressing health issues.”
“Combating the opioid epidemic is a national priority,” Burwell said.
The CDC suggests that physicians choose therapies other than opioid painkillers, such as non-steroidal anti-inflammatory drugs (NSAID), like ibuprofen or acetaminophen, exercise routines, behavioral therapy and injections. If it’s deemed necessary to prescribe opioid painkillers, clinicians should prescribe the minimum dose possible and closely monitor patients for signs of abuse. The guidelines also suggest that three days of opioid painkillers should be effective in treating short-term acute pain, often a part of recovery from surgery or trauma. Leftover prescriptions kept in homes have long been a source of abuse for teenagers and other family members.
The American Medical Association stated that it was “largely supportive” of the guidelines but open minded for “possible unintended consequences.”
“We know this is a difficult issue and doesn’t have easy solutions and if these guidelines help reduce the deaths resulting from opioids, they will prove to be valuable,” said Dr. Patrice A. Harris, chair of the AMA Task Force to Reduce Opioid Abuse.
Dr. Lynn Webster, the former president of the American Academy of Pain Medicine and a consultant to drug companies developing pain drugs, stated that opioid painkillers worked well for some patients.
“That doesn’t mean it’s optimal treatment, and there are many side effects,” he said. He said the CDC should acknowledge the problem with untreated pain as it tries to solve the opioid crisis, and he called on Congress to fund a “Manhattan Project” for better medications.
“We need drugs that aren’t addictive,” he said.
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Opioids Medication Alternatives
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