Underlying Factors in Drug Overdose Deaths | Substance Use and Addictive Disorders | JAMA | The JAMA Network – October 11, 2017
JAMA Viewpoint: Deborah Dowell, MD, MPH; Rita K. Noonan, PhD; Debra Houry, MD, MPH
This is the “viewpoint” of the very influential Dr. Houry, the Director of the National Center for Injury Prevention and Control (NCIPC) at CDC, who has been instrumental in restricting prescription opioids.
Since 2010, overdose deaths involving predominantly illicit opioids (heroin, synthetic nonmethadone opioids, or both) have increased by more than 200% (Figure).
Chronic pain and opioid misuse: a review of reviews – Open Access (free full-text) – August 2017
The review found a high rate of pre-existing pain among non-medical Rx opioid users and found only a low level of opioid use disorder among pain patients.
The crisis of prescription opioid (PO) related harms has focused attention toward identifying and treating high-risk populations. This review aims to synthesize systematic reviews on the epidemiology and clinical management of comorbid chronic pain and PO or other substance misuse.
A systematic database search was conducted to identify systematic reviews published between 2000 and 2016. Continue reading
What Science Says To Do If Your Loved One Has An Opioid Addiction | FiveThirtyEight – by Maia Szalavitz
This is a well-referenced article providing an overview of the latest scientific understanding of opioid addiction – and the data show that pain patients are NOT likely to be addicted to their opioid medication.
Much of the advice given by treatment groups and programs ignores what the data say in a similar way that anti-vaccination or climate skeptic websites ignore science
The addictions field is neither adequately regulated nor effectively overseen.
“There’s nothing professional about it,
and it’s not evidence-based,” Continue reading
Remarkable Increases in Alcohol Use Disorders | Psychiatry | JAMA Psychiatry | The JAMA Network
The root problem of the “overdose crisis” is not opioids, but addiction in general, which can also manifest with alcohol:
This issue of JAMA Psychiatry includes a timely article by Grant et al that makes a compelling case that the United States is facing a crisis with alcohol use, one that is currently costly and about to get worse.
The article reminds us that the chilling increases in opioid-related deaths reflect a broader issue regarding additional substance-related problems.
Taking On the Scourge of Opioids | National Affairs | Summer 2017 By Sally Satel
This article is especially noteworthy because this political publication, “its founding editor, Yuval Levin, and authors are typically considered to be conservative.”
The author describes the origin and current state of the “opioid issue” in great detail and reasonably concludes that “factors beyond physical pain are most responsible for making individuals vulnerable to problems with opioids”
An estimated 2.5 million Americans abuse or are addicted to opioids — a class of highly addictive drugs that includes Percocet, Vicodin, OxyContin, and heroin. Continue reading
Will Strict Limits on Opioid Prescription Duration Prevent Addiction? Advocating for Evidence-Based Policymaking: Substance Abuse: Mallika L. Mundkur , MD, MPH, Adam J. Gordon , MD, MPH & Stefan G. Kertesz , MD, MSc – Jun 2017
Quick answer: NO!
In 2016, the Centers for Disease Control and Prevention (CDC) issued the first national guideline in the United States regarding opioid prescribing for pain.
The guideline included the recommendation that patients treated for acute pain should receive opioids for no longer than 7 days, prompting at least five states to implement laws requiring prescribers not to exceed this threshold when providing initial opioid supplies.
The rapid conversion of this guideline into policy appears to reflect an underlying assumption that limiting initial opioid supplies will reduce opioid consumption, and thus addiction. Continue reading
Opioid Addiction Isn’t The Disease; It’s The Symptom | HuffPost – 06/16/2017 – by Clay Marsh, Contributor Vice President and Executive Dean for Health Sciences, West Virginia University
The same issues leading to the opioid epidemic are what drives the tremendous cost and disease burden of our country at large.
The opioid epidemic is merely a symptom of a much larger crisis, one we as Americans must learn to solve: the crisis of isolation, despair and hopelessness. …communities are crucial to our wellbeing: irrespective of genus, the most psychologically damaging experience any young creature, human or animal, can have is being separated from the group and abandoned to fend for itself.
And yet, increasingly, more and more of us are, in a way, abandoned and afraid.
Lyrica and Neurontin Linked to Opioid Overdoses — Pain News Network – May 2017
“It is important that doctors and people dependent on opioids are aware that the number of overdose deaths involving the combination of opioids with gabapentin or pregabalin has increased substantially and that there is evidence now that their concomitant use – either through co-prescription or diversion of prescriptions – increases the risk of acute overdose deaths,” said Matthew Hickman, a Professor of Public Health and Epidemiology
The idea that Lyrica and Neurontin are being abused may be surprising to many patients and doctors, but the drugs are increasingly being used by addicts. Continue reading
The myth that prescriptions caused the opioid crisis | News & Observer | Apr 2017 by Thomas F. Kline, MD. Ph.D
“Job One” in the medical profession is to relieve pain. Prescription controls always sound good but don’t work and harm those who are seriously in pain.
Opioids (narcotics) are the only class of medicine to control real pain.
Out of 100 people taking pain medicine, only a very few, perhaps three or four, will develop an addiction. Restricting pain medicine in the other 97[%] is not good medical practice. Continue reading
Opioid Abuse in Chronic Pain — Misconceptions and Mitigation Strategies — NEJM – Nora D. Volkow, M.D. [Director of the National Institute on Drug Abuse (NIDA)], and A. Thomas McLellan, Ph.D. – Mar 2016 – free full-text article
Chronic pain not caused by cancer is among the most prevalent and debilitating medical conditions but also among the most controversial and complex to manage.
The urgency of patients’ needs, the demonstrated effectiveness of opioid analgesics for the management of acute pain, and the limited therapeutic alternatives for chronic pain have combined to produce an overreliance on opioid medications in the United States, with associated alarming increases in diversion, overdose, and addiction
Here, we draw on recent research to address common misconceptions regarding the abuse-related risks of opioid analgesics and highlight strategies to minimize those risks. Continue reading