Millions are addicted to or dependent on prescription opioids. Worse than the dependency, over 200,000 deaths are attributable to prescription opioids, as well as hundreds of thousands of overdoses. What’s the biggest contributor to the epidemic, you ask? Most commonly, it’s the inappropriate prescription of opioids for the treatment of issues like musculoskeletal disorders, chronic low back pain, headaches, and other issues.
Insights from a Leading Pain Expert
A recent study conducted by leading pain expert Gary Franklin, MD, MPH, V.P. of Physicians for Responsible Opioid Prescribing, provides substantial evidence that prescribing opioids for chronic pain offers no real benefit. Franklin has been striving to shed light on this issue which is believed to be contributing in large part to the prescription opioid abuse epidemic sweeping the nation. Opioids such as hydrocodone and oxycodone have increased in prescription from around 76 million in 1991 to nearly 207 million in 2013, making the U.S. the biggest global consumer for these products at nearly 100% of word consumption for hydrocodone, 81% for oxy. Most notably, Dr. Franklin’s research found clear evidence of dose-dependent risk for serious harm:
- A dramatic increase in death with opioids administered at a dose of 100mg MED (morphine equivalent dose).
- A risk of overdose 2-5 times higher when the above MED runs between 50-99mg.
- Doses lower than 100mg MED still result in overdose – even without long-term therapy.
- Opioids administered in combination with benzodiazepines, sedative-hypnotics, or muscle relaxants dramatically increase the risk for harm.
- Double the risk of remaining on disability 1 year for those treated with opioids for at least 7 days (cumulative dose: 150mg MED).
Reversing the Trend
Believed to be the direct result of poor research and outdated teaching practices, the most important step toward reversing the opioid epidemic is simple- putting a stop to improperly prescribed opioids particularly for chronic pain. To aid this effort, the American Academy of Neurology and a number of states have produced product guidelines advising against the use of opioids for the treatment of musculoskeletal conditions, headache, or fibromyalgia, and additionally advising physicians to proceed with caution when initiating opioid therapy for pain or long-term use. (Since released, the guidelines created as a result of the drug utilization review have effected a 30% sustained decline in overdose deaths and a substantial decline in injured workers on chronic opioids in Washington State.)
Evidence-based Alternatives
Opioid therapy is not necessarily the only answer to treating chronic pain. Drug utilization review programs such as ANS Pharmacotherapy Review can provide alternative therapy recommendations. ANS deploys an exceptionally credentialed network of nurse experts to deliver recommendations in face-to-face meetings with treating physicians. These recommended treatment options are equally, if not more effective than opioids. Better still, they offer improved quality of care and quality of life for the injured worker.
If the pitfalls of opioid therapies are taking over your workers’ comp claim settlements, the proven drug utilization review protocols at ANS Solutions can show you a better path. Optimized outcomes for the injured worker are possible. Contact ANS today or visit www.ans-solutions.com.
This content was originally posted at http://ans-solutions.com/no-proven-benefit-for-the-use-of-opioids-in-chronic-pain/
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