So, here’s what’s coming from your government with regards to opioid prescription rules and policies:
Eight Critical Trends in Opioid Prescribing to Watch
- Raw numbers of opioid prescriptions are declining significantly.
From 2012 to 2017, opioid prescriptions declined 22%, says an April 2018 report from the IQVIA Institute for Human Data Science. The report says Prescription Drug Monitoring Programs (PDMPs) are a notably important factor (among many) in this decline. Federal and state authorities and medical academics are pressuring MDs not to write opioid prescriptions for chronic pain.
This is both good and bad news. The bad is that physicians may be unreasonably scared to write needed opioid prescriptions.
What should physicians do? There are alternatives, but they may not be covered by insurance. Some patients, especially those in chronic pain (other than cancer patients, who get a “bye” in this national debate), seem to have little alternative but to turn to the black market for pain relief.
- Scary headlines will continue to trump scientific facts, to the detriment of patients in pain, and to the peril of prescribers.
A major example: The CDC published a study on March 17, 2017 saying that 2.6% of patients who were initially prescribed opioids were still on opioid prescriptions after a year.
Here were the headlines on this study found on Google:
“Opioid Painkiller Addiction Can Start Within Just a Few Days” – CBS News
“CDC Study Finds Opioid Dependency Begins Within a Few Days of Initial Use” – Highly respected science writer Jessica Wapner wrote in Newsweek.
Wapner also wrote, “As with any epidemic, understanding the epidemiology of drug addiction is crucial to ending it. That means knowing who is at risk, how it ‘spreads’ and the characteristics of the people who become addicted.”
Addiction starts in a few days on pain prescriptions? Is that really what the CDC study said?
No. Nothing of the sort. In fact, the study’s authors acknowledged that they didn’t even ask that 2.6% whether they still had pain without their prescriptions. What it did say was that even when the initial prescription is as short as five days, some patients were still on opioid prescriptions a year later. It said nothing correlating initial prescriptions with addiction.
We asked the news media offices at the Centers for Disease Control (CDC), the National Institute on Drug Abuse (NIDA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) about the news coverage of that study, and whether they could cite studies on causal links between legitimate prescriptions and OUD.
The CDC said it would get back to us but didn’t respond in time for this article.
A SAMHSA spokesman said that a search turned up nothing relevant to the question, but he found a 2013 study which concluded that non-medical use (that is, misuse) of prescription opioid pills leads to heroin use. That study also said that the reformulation of OxyContin in 2010 to reduce its misuse potential lowered the street price of OxyContin and “may have led potential abusers of OxyContin to switch to heroin.”
An NIH [National Institutes of Health] media relations staffer wrote back, “[Y]ou are correct that the news media interpretation that 5 days of opioid treatment leads to addiction is an inaccurate interpretation of that paper.”
