If Lawmakers Really Want to “Follow the Science” They Will Repeal Codified Opioid Guidelines

This study documents a relationship between opioid prescribing and opioid overdose in a large, national, prospective cohort of individuals receiving opioid therapy for a variety of medical conditions. The risk of opioid overdose should continue to be evaluated relative to the need to reduce pain and suffering and be considered along with other risk factors.University of Alabama Professor of Medicine Stefan Kerteszpointed out thatfollow up research led by Bohnert found the median overdose dosage was 60 MMEs and 86 percent occurred under 90 MMEs. Yet he cautioned policymakers:Reliance on a simple binary dose metric is an extremely poor method for identifying persons at risk for adverse events while receiving opioids. It is insensitive and non-specific......The correlation between dose prescribed and overdose event is a real finding. However, high prescription dose appears in large part to serve as amarker for multiple psychological and social vulnerabilities. This does not mean that every person receiving high doses has such vulnerabilities. However, it does suggest such vulnerabilities are likely to play a confounding role in the prediction of overdose events in large correlational data analyses. (emphasis in the original)But that ’s not all that is wrong with using morphine milligram equivalents to guide opioid prescribing.Pharmacology tells us that fixed doses of opioid drugs ignore the substantial genetic differences in metabolism between individuals. For example, the lev...
Source: Cato-at-liberty - Category: American Health Authors: Source Type: blogs