The Center for Disease Control and Prevention (CDC) published on Tuesday the first national standard guidelines for doctors to limit prescribing of opioid painkillers.
In general, the risk from those prescription narcotic painkillers, including Oxycontin, Percocet, and Vicodin, far outweigh the benefits for most people. The agency’s director said that they could lead to a pervasive and deadly epidemic in the U.S. if being overused.
The new standards encourage primary-care clinicians, involving doctors, physician assistants and nurse practitioners, to consider something besides an opioid when first treating pain before prescribing such highly addictive pills. They could be alternative treatments like ibuprofen, physical therapy, ice and talk therapy. Since doctors have prescribed them more often and in higher quantities than may be best for patients, they are attempting to restrain growing rates of addiction to opioid drugs.
They suggest doctors should only prescribe opioid painkillers for a week at most, in other words, the lowest effective dosage possible for the shortest amount of time to those who do need opioid drugs. Because the drugs are highly addictive, the primary-care clinicians should monitor the patients cautiously.
“If you’re prescribing an opiate to a patient for the first time, that’s a momentous decision,” CDC Director Tom Frieden said. “That may change that patient’s life for the worse forever. So you’ve really got to think carefully before doing it.”
If it is possible, chronic pain should not be treated at all with the drugs. In cases where these are not effective, or effective enough, careful consideration of risks should be considered, with specific goals for their use set out before starting.
CDC encourages doctors to limit opioid presciptions for patients suffering short-term, acute pain to maximum of 3 days, and says that more than 7 days’ worth of the drugs “will rarely be needed”.
As a report of CDC, there are approximately 40 deaths of Americans each day due to overdose of such prescription morphine-like, addictive painkillers. It was estimated that in 2013, 1.9 million people abused or were dependent on them. In 2014, opioids were involved in more than 28,600 deaths, or 61% of all drug overdose deaths.
In other words, the rate of drug overdose deaths from opioids, including prescription painkillers and heroin, tripled between 2000 and 2014, and deaths from opioid painkillers alone rose 9% in 2014.
Due to the alarming figures, CDC hopes this new guidelines can become a benchmark for medical practice, but not an unbending dictate, to protect patients.
“It’s the first time the federal government has clearly communicated to the medical community that widespread and routine practice of treating long-term chronic pain with opioids is inappropriate,” said Dr. Andrew Kolodny, Executive Director of Physicians for Responsible Opioid Prescribing.
“The urgency of the epidemic, its devastating consequences, demands interventions that, in some instances, may make it harder for some patients to get their medication,” said Dr. Nora Volkow, the Director of the National Institute of Drug Abuse. “We need to set up a system to make sure they are covered. But we cannot continue the prescription practice of opioids the way we have been. We just can’t.”
There are, however, still several cases actually needed to be prescribed with the opioid painkillers.
According to Deborah Dowell, Senior Medical Adviser in the Division of Unintentional Injury Prevention at the CDC’s National Center for Injury Prevention and Control, patients should ask some questions if the doctors prescribe opiates:
– Is an opiate necessary?
– What are the risks?
– What are the benefits?
– How long should I take this?
– Are there alternatives?
– What we hope to accomplish by using an opiate?
– How will you know when we’ve met our goal?