Opioid Addiction Targeted by Surgeon General
In a first-of-its-kind report, the U.S. Surgeon General last week announced plans to tackle alcohol and drug abuse—especially opioid addiction—urging doctors, policymakers and the public to ramp up efforts to combat the the growing U.S. healthcare crisis.
Consumer Reports medical advisors have long urged a cautious approach for people using potent painkillers like Oxycontin and Vicodin and the doctors prescribing them, and offered alternative solutions to pain management.
Underpinning the report, “Facing Addiction in America,” by U.S. Surgeon General Vivek H. Murthy, M.D., M.B.A, is his desire for us to understand that addiction is an illness—not a moral failing.
Murthy's report details the scientific evidence that demonstrates the value of early medical intervention and the success of addiction treatments for all types of substance addiction.
He notes that both of these actions are underutilized by healthcare professionals, citing that only 1 in 10 people receive the treatment they need to resolve their addiction. Opioid Addiction a Key Concern
While the report takes on alcohol, illicit and prescription pills of all kinds, it makes a special focus on substantially reducing prescription opioid addiction and misuse.
The Surgeon General’s underscored the need for urgent action—and calling for more responsible prescribing by doctors.
“As clinicians, we have to ask ourselves, ‘do the harms outweigh the benefits of prescribing this medicine?’” said Murthy, M.D., M.B.A., during a media call last week on the launch of the report.
The report urges healthcare professionals to better adhere to the Centers for Disease Control and Prevention new opioid prescribing guidelines.
"The pathway between the relief of pain and ‘doing no harm’ is frequently a narrow one for your doctor," says Consumer Reports chief medical adviser Marvin M. Lipman, M.D. "But the dreadful results of inappropriate opioid prescribing have tipped the scales in favor of revising your doctor's prescribing habits."
Since 2000, the rate of overdose deaths involving opioids—Fentanyl, Percocet, Vicodin, and others—has increased by 200 percent, according to the Centers for Disease Control and Prevention (CDC).
And in 2014 alone, nearly 30,000 people died from a drug overdose involving some type of opioid, including prescription pain relievers and heroin—more than in any previous year on record. How to Stay Safe
According to recent prescribing guidelines issued by the CDC, doctors must change how often they prescribe drugs like Oxycotin, Percocet or Vicodin, and for which patients. No longer can doctor's assume that people who are in legitimate pain are not at risk for opioid addiction, as been standard medical practice for decades, the report notes.
What's important is that the CDC’s analysis shows that the longer a person takes opioids, especially at the higher doses, the greater the risk for serious effects, including addiction, overdoses, and death. That’s true even if you use the drugs legitimately to combat pain.
While most people taking opioids don’t become addicted, nearly everyone who takes the drugs longer than a couple of weeks or so becomes dependent on them.
According to the CDC, you can lessen that risk by, whenever possible, not taking the drugs longer term. That means if you’re treating severe short-term pain from an injury or surgery, taking a shorter course—three day’s worth—is a better bet.
If your pain persists after a few days, discuss with your doctor non-opioid alternatives, including other types of pain drugs as well as nondrug approaches, such as exercise and cognitive behavior therapy.
"There are pain-relieving treatments and medications other than opioids that are of use in helping benign but chronic pain syndromes," adds Lipman.
A Renewed Push for Interventions
Murthy also pointed to the need for improved public understanding of prescription painkiller risks and called the patient’s role “an absolutely essential part” of fighting opioid addiction.
Simple acts, like not sharing your prescription and storing the drugs in a safe place are easy first steps. “Sometimes the worst place to keep them is in your medicine cabinet,” added Murthy.
On a system level, the Surgeon General asks for other policy changes, such as increased use of prescription drug monitoring programs (PDMPs), designed to curb the rate of inappropriate prescribing of opioid pain relievers. Better Access to a Life-Saving Drug
The report also calls for better access to the overdose rescue drug, naloxone. Naloxone is an FDA-approved medication that prevents death from an opioid overdose by immediately blocking the drug from receptors in the brain that would otherwise slow down a person’s heart rating and breathing rate.
Recent price hikes have severely threatened access to the drug for hospitals, public health departments, and nonprofits. Nearly three dozen states including Arkansas, California, Massachusetts, Minnesota, and Oregon allow a patient to get naloxone without a prescription.