Opioid-related deaths and drug overdose deaths in the United States continue to increase. From 1991 to 2011, prescription opioids tripled from 76 million to 219 million on an annual basis. Between 1997 and 2006, sales of opioids increased by: 244% for hydrocodone, 732% for oxycodone, and 1177% for methadone. From 2000 to 2015, over half a million individuals died from drug overdoses. Over the last 20 years, the number of deaths from prescription opioids has quadrupled. Nowadays, an individual in the United States dies from opioid overdose every 19 minutes!
The opioid epidemic, also known as the opioid crisis, is referred to as the hasty increase in the use of prescription and non-prescription opioids in the United States and Canada in 2010. Statistics show that the opioid epidemic in the United States in 2015 had led to:
- 12.5 million individuals misusing prescription opioids;
- 2.1 million individuals misusing prescription opioids for the first time;
- 15,281 deaths resulting from overdose on commonly prescribed opioids;
- 828,000 individuals using heroin;
- 135,000 individuals using heroin for the first time;
- 12,989 deaths resulting from heroin overdose;
- $78.5 billion dollars in economic costs
Today, drug overdose is the leading cause of unintentional death in the United States. One major contributing factor is the increased use of opioids. Opioids, a group of strong painkillers such as oxycodone and hydrocodone, have become the most prescribed group of medications in the United States. Nonmedical use of prescription opioids possesses a threat; however, repeated use of these medications can lead to drug abuse or even worse, death. To address the complex issue of prescription opioids and heroin abuse, it is important to confront the growing impact of such issues on health and mortality. As a healthcare professional, it is equally important that you help to preserve the role of drug prescriptions by educating yourself and your patients on the subject, all the while providing relief from suffering. After all, the opioid epidemic did not arise from greedy pharmaceutical companies but rather from compassionate doctors, such as you, who were only doing your job to help end the suffering of patients in pain.
Doctors play a vital role in drug prescription misuse and abuse prevention. A comprehensive approach to reducing the risk of misusing and abusing drug prescriptions is educating yourself on safe and appropriate opioid prescribing. For instance, the SAMHSA – the Substance Abuse and Mental Health Services Administration – offers an educational course that is targeted towards helping doctors provide specific knowledge and skills on safe and appropriate opioid prescribing. It also addresses clinical strategies for managing patient situations that prove to be rather difficult. The project is designed to integrate prescription medical history information from prescription monitoring programs into doctor and pharmacy systems for the purpose of empowering informed decision making at the point of care.
Being involved in such training programs can help you to give back and educate your patients. You can perform tests and physical examinations on patients to identify signs of drug abuse or dependence and you can also take note of any increased requests for prescription refills. Most important, you can learn how to talk with patients about the negative effects of misusing drug prescriptions. Ensure that they are properly using drug prescriptions by informing them to:
- Throw away used or expired drug prescriptions;
- Store prescription opioids and sedatives safely;
- Follow the instructions on the drug label or the instructions provided by the pharmacist;
- Never use another individual’s drug prescription;
- Never give their own drug prescription to another individual;
- Never stop treatment or change dosages without consulting with a doctor first;
- Be aware of the potentials risks associated with a particular drug;
- Be honest about all prescriptions, over the counter drugs, diet pills, and herbal supplements that they may be taking
Encouraging referrals to pain/addiction specialists or pain management programs when appropriate is another option. In addition to performing routine tests, referring patients to specialists may be of great advantage to those who are at an increased risk of prescription opioid abuse. It may be more costly in the short-term; however, it can help to manage their conditions in the long run.
Prescription monitoring programs is another excellent approach in preventing opioid misuse and abuse. Prescription monitoring programs are data collection systems take into account the number of doctors who prescribe opioids for each patient and the number of pharmacies where opioids are distributed for that particular patient. Such programs are typically administered on a state by state basis and they collect information relating to each prescriber, pharmacy, product name, dose, and more. Therefore, they can be used to limit the prescription of opioids to abusers. Once a patient has reached their limit, the doctor will be notified. If further action needs to be taken due to suspicious activity, the patient can be referred to law enforcement for further investigation.
An increasing number of cases associated with drug abuse relate to identity theft. Therefore, in order to avoid such charges, it may help if you work with local pharmacies. Most pharmacists require patients to present photo identification when picking up their prescriptions. If you or the pharmacist believes a patient is portraying suspicious activity, it can help to contact one another in such situations. Simply spreading the word and emphasizing the importance of photo identification can help to control substance abuse and reduce insurance fraud.
Another important approach in preventing inappropriate medical prescribing and medical errors includes establishing measures to help identify mismatches between diagnoses and dosages. As of June 1, 2010, the US Drug Enforcement Administration issued a regulation, approving the use of electronic prescribing for the purpose of controlling substance abuse in the United States. Setting up such systems can help educate you in safe opioid prescribing and they can also help you to avoid medical errors, and malpractice lawsuits. Moreover, prescription forgery can be reduced as most prescription errors are caused by illegible handwriting.
Patient monitoring programs, electronic prescribing, and electronic health records have become a universal use throughout the medical community in identifying and preventing drug prescription misuse. Such tools help predict trends relating to substance abuse statistics and variables based on genetics, demographics, and other information. In fact, in some states, they have been associated with lower rates of opioid addictions and overdose. Most important, they have become vital tools for providing accurate information and efficient patient care across the country.
As it stands, more than 80% of Americans have contact with a doctor within a year. This places you in a unique position to find the balance between justifiable medical needs of patients and the potential risks associated with drug misuse or other related harms. Generally speaking, the population of patients who require long term treatment with opioids is rather small. Although many patients with chronic pain benefit from prescription opioids, there are those who are vulnerable to drug abuse and addiction. As a matter of fact, there are a number of procedures that can be used to improve functionality, ease symptoms, and improve quality of life without the use of opioids. Injections, physical therapy, and diagnostic tools such as imaging or surgery are all approaches that are intended to reduce reliance on long term use of opioids.
Not all types of pain respond well to treatment with opioids and they carry with them a significant risk. By educating yourself on the use and effects of opioids, you can recognize when a problem exists and refer patients to appropriate treatment plans. What’s more, by educating your patients, you can establish strong partnerships with respect to medical decisions and recommendations. They need to understand the risks associated with such prescription drugs and you have to be the one to tell them. It’s a real responsibility but by investing some time and effort, you can take preventive measures in reducing the misuse and abuse of opioids.