Policymakers Obsess Over Pain Prescribing and Ignore the Giant Elephant in the Room: Prohibition

Jeffrey A. SingerOn January 20th, theCincinnati Enquirer ran a story on the recentreport from the Centers for Disease Control and Prevention that showed a 30.1 percent drop in prescription opioid volume from 2010  – 2011 to 2016 – 2017. While the CDC report was non‐​judgmental, it was greeted by hospital administrators and emergency physicians in the Cincinnati area as good news.The article quotes one physician/ ​hospital spokesperson as saying:“The patient can know, ‘My encounter with the ED will … lead to a good outcome. I will not be exposed to unnecessary threats … downstream.’“They will treat the pain in a safe way. ”I was interviewed for the story and shared with the reporter my experiences as a general surgeon seeing patients referred from emergency departments in excruciating pain who were given minimal pain medication  — sometimes justTylenol(acetaminophen) or ibuprofen  — for conditions needing urgent surgical intervention. I told reporter Terry DeMio “It means a lot of people are getting under ‐​treated for pain.”Policymakers, including those in hospital and health care administration, refuse to accept the federal government data showingno correlation between prescription volume and the non ‐​medical use of opioids or opioid use disorder among persons aged 12 and over. Theyignor...
Source: Cato-at-liberty - Category: American Health Authors: Source Type: blogs

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Authors: Hanna MN, Chambers C, Punyala A, Iqbal A, Singh B, Oruc C, Prakash P, Prajapati Y, Wang Y, Amery Ai Z, Shechter R, Speed TJ, Koch CG, Williams K Abstract The use of opioid analgesics for pain management has increased dramatically over the past decade, with corresponding increases in negative sequelae including overdose and death. Physicians, policymakers, and researchers are focused on finding ways to decrease opioid use and overdose. This crisis calls for a coordinated response that includes the entire healthcare sector. In this work, the authors lay out a blueprint for such a response at the level of the...
Source: Journal of Opioid Management - Category: Addiction Tags: J Opioid Manag Source Type: research
CONCLUSIONS: Utilization of drugs that harness endogenous opioid antinociception in accordance with varying physiological states represents a novel approach for effective pain management while mitigating the present epidemic of death by synthetic opioid overdose. PMID: 32091619 [PubMed - as supplied by publisher]
Source: Journal of Opioid Management - Category: Addiction Tags: J Opioid Manag Source Type: research
CONCLUSION: Overall, PP patients felt the benefits of opioid use outweighed the risks, and using opioid medication sig-nificantly improved their quality of life. This may be partly due to the poor efficacy of other nonprescription medications and complementary therapies in managing PP beyond short-term relief. PMID: 32091612 [PubMed - as supplied by publisher]
Source: Journal of Opioid Management - Category: Addiction Tags: J Opioid Manag Source Type: research
In 2011, Florida established a Prescription Drug Monitoring Program and adopted new regulations for independent pain-management clinics. This paper examines the association of those reforms with drug overdose deaths and other injury fatalities. Florida's p...
Source: SafetyLit - Category: International Medicine & Public Health Tags: Alcohol and Other Drugs Source Type: news
CONCLUSIONS: Given increasing rates of opioid addiction and death, viable solutions are universally needed. Successful intervention measures should be widely shared between military, veteran, and civilian healthcare and public health communities. Increased collaboration between these groups could inculcate successful programs to prevent and decrease opioid use. Results received from recent military and veterans' programs for prescription and electronic medical record (EMR) monitoring and data sharing may also prove useful for civilian healthcare providers and hospital systems. Future evaluations from ongoing federally fund...
Source: Military Medicine - Category: International Medicine & Public Health Tags: Mil Med Source Type: research
Abstract Opioid overdose mortality has been increasing in the US, and other types of mortality, such as car crash deaths may also be linked to opioid use. In this issue of the Journal, Feder et al. (Am J Epidemiol. XXXX(XX):XXXX-XXXX)) examine the association between Florida's opioid crackdown laws and opioid-related mortality. They found a decrease in opioid overdose and car crash deaths compared to what would have been expected in the absence of such policies. The study found no evidence of any unintended increase in suicides due to poor pain management as a result of the policy. The results are robust to altern...
Source: Am J Epidemiol - Category: Epidemiology Authors: Tags: Am J Epidemiol Source Type: research
Abstract In 2011, Florida established a Prescription Drug Monitoring Program and adopted new regulations for independent pain-management clinics. This paper examines the association of those reforms with drug overdose deaths and other injury fatalities. Florida's post-reform monthly mortality rates - for drug-involved deaths, motor vehicle crashes, and suicides by means other than poisoning - were compared to a counterfactual estimate of what those rates would have been absent reform. The counterfactual was estimated using a Bayesian structural time-series model based on mortality trends in similar states. By Dece...
Source: Am J Epidemiol - Category: Epidemiology Authors: Tags: Am J Epidemiol Source Type: research
New largescale study in the American Journal of Preventive Medicine found overprescription of opioids by dentists common, particularly to patients at high risk for substance abuse, and that almost 1/3 of patients received more powerful drugs than neededElsevierIMAGE: In this cross-sectional analysis of 542,958 dental visits by adult patients, between 1 in 4 and 1 in 2 opioid prescriptions exceeded the recommended morphine equivalents and days'supply for...viewmore Credit: Michelle S. Woods Ann Arbor, February 4, 2020 - Dentists are among top prescribers of opioids in the US, however, whether their opioid prescrib...
Source: Dental Technology Blog - Category: Dentistry Source Type: news
Conditions:   Opioid Use;   Post-thoracotomy Pain Syndrome;   Local Anaesthetic Agent Overdose;   Local Anesthetic Complication;   Pain, Postoperative Intervention:   Procedure: Serratus anterior block Sponsor:   Indiana University Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
AbstractThe United States is in the midst of an opioid overdose epidemic, with a significant portion of the burden associated with prescription opioids. In response, the CDC released aGuideline for Prescribing Opioids for Chronic Pain, which promotes access to treatment for opioid use disorder. Decades of research have linked childhood adversity to negative health and risk behavior outcomes, including substance misuse. Our present study builds upon this work to examine the relationship between adverse childhood experiences (ACEs) and prescription opioid misuse. We compiled data from the Behavioral Risk Factor Surveillance ...
Source: The Journal of Primary Prevention - Category: Sleep Medicine Source Type: research
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