Pubdate: Mon, 28 Mar 2016
Source: Seattle Times (WA)
Copyright: 2016 The Seattle Times Company
Contact:  http://seattletimes.nwsource.com/
Details: http://www.mapinc.org/media/409

MORE HELP TO FIGHT OPIOID HEALTH CRISIS

AMERICA is in the grip of a prescription-drug-abuse crisis. More than 
40 people die every day from overdoses involving prescription opioids.

That number equals more than 165,000 opioid-overdose deaths since 
1999, a baseline year that marks the quadrupling of opioids 
prescribed and sold to date. Or as the federal Centers for Disease 
Control and Prevention notes in its statistics, in 2013 alone enough 
prescriptions were written for every American adult to have a bottle of pills.

Many Americans suffer from pain, but the use and abuse of 
prescription opioids have soared past those receiving active cancer, 
palliative and end-of-life care.

Opioid abuse, and the heroin use it can lead to, has flummoxed the 
health-care industry as well. Earlier this month, more help was 
offered. The CDC Guideline for Prescribing Opioids for Chronic Pain 
was published to help primary-care providers.

The dozen CDC recommendations are a welcome response to "a national 
health crisis," explains Dr. David Tauben, chief of the Division of 
Pain Medicine at the University of Washington, and medical director 
of the UW Center for Pain Relief.

Most primary-care providers - including family doctors, dentists, 
podiatrists and nurse practitioners - are not well educated in the 
hazards of opioids and opioid dosage, and the need for patient 
monitoring, Tauben said.

Besides a desire to take away pain and make their patients better, 
they have the pharmaceutical industry, patient advisory groups and 
patients pushing for opioid prescriptions.

Lessons have been learned, including the fact that there is no safe 
dose. The opioid dosage in most pills is quite high. And the health 
risks for patients rise early.

The first recommendation for primary-care providers is not to start 
with opioids. Begin with nonopioid pain relievers and other 
treatments, including exercise therapy and weight loss.

Other guidelines include starting with the lowest effective dose, the 
use of immediate-release opioids and short-duration prescriptions for 
acute pain - perhaps for three days, not weeks and months.

Oversight and patient evaluation are key, and that includes the use 
of urine drug testing to assess how patients are following the 
prescription directions, and if they are using other prescriptions 
and illicit drugs, risking dangerous interactions, Tauben said.

This is an urgent national issue. President Obama has asked Congress 
for $1.1 billion to help states cover care for opioid abusers. Obama 
is scheduled Tuesday to address the National Rx Drug Abuse and Heroin 
Summit in Atlanta.

Opioid abuse touches lives across America. And even trained medical 
providers need more help and information to confront the crisis.
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MAP posted-by: Jay Bergstrom