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  1. Beenthere2Hippie
    About half of opioid overdose deaths involve prescription drugs. With that stark fact in mind, the surgeon general, Dr. Vivek Murthy, sent an unusually direct plea last week to 2.3 million doctors and other health care workers to help fight the opioid epidemic by treating pain “safely and effectively.” A website for his “Turn the Tide” campaign highlights alternative, nonaddictive treatments for pain. Not only doctors but also policy makers, insurance companies and other players in the health care system should pay attention.

    Prescriptions for opioids such as oxycodone and methadone have quadrupled since 1999, as have opioid overdose deaths — more than 28,000 in 2014, up 14 percent from the year before. While prescriptions for opioids peaked in 2012, their use remains high by historical standards. And many people who were prescribed opioids have gone on to use illegal opioids like heroin and fentanyl.

    For cancer patients or people near the end of their lives, opioids are often the only effective medicine. But doctors have many more options for treating back pain, migraines and pain related to surgery — physical therapy, anti-inflammatory drugs, acupuncture, exercise and so on. Some doctors overlook these alternatives because opioids are easy to prescribe or because patients demand them.

    A further problem is that some insurance plans do not cover alternative treatments like physical therapy and acupuncture, or they impose so many limits and high co-pays on them that in many cases both doctors and patients find opioids a less expensive option. In some rural areas, the nearest physical therapist may be many miles away.

    One fix here seems obvious: Federal and state lawmakers can require insurers to cover these services, a cheaper option over the long term than addiction treatment. And they should also find ways to expand access to health services by subsidizing doctors, therapists and other health care workers to make periodic visits to remote areas.

    Even when opioids are necessary, doctors can minimize the risk of addiction by taking a few precautions. They can write prescriptions for low doses and relatively short time periods. They should pay attention to monitoring programs that most states have set up to make sure a person is not getting multiple prescriptions from different doctors. And doctors can steer to treatment patients who are obviously addicted.

    Doctors are not the only ones responsible for the opioid epidemic, but as Dr. Murthy makes clear, they’ll have to play a leading role in the fight against it.


    By the NY Times Editorial Board/Aug. 30, 2016
    http://www.nytimes.com/2016/08/30/o...y-a-critical-role-in-the-opioid-epidemic.html
    Illustration: Na Kim, nytimes
    Newshawk Crew

    About Author

    Beenthere2Hippie
    BT2H is a retired news editor and writer from the NYC area who, for health reasons, retired to a southern US state early, and where BT2H continues to write and to post drug-related news to DF.

Comments

  1. AKA_freckles
    This is garbage. Doctors have to write a hard copy every 30 days now, so short periods is already the strategy du jour.

    Perdue, the makers of Oxycontin should be paying for a huge part of the cost here. They are almost singularly responsible for the "non addictive" initial belief when it hit the market, and the resulting "patient led" pain medication management that got us here today. They have made billions from this.

    I mean, I love opiates, and I love pills, but the amount of pain this is causing is ridiculous.
  2. DocToxin8
    I think the reverse is true here, regarding most pills that can be abused.
    Sure, some people (perhaps quite many) do get addicted to prescription meds,
    BUT, when you're a patient trying to get some anxiety relief and all the doctor throws at you are antipsychotics because he's afraid of repercussions from the bureaucracy doc. (Not sure how to directly translate it, but a doctor overseeing prescriptions)
    then THAT is an equally big problem.

    I say, let people take responsibility themselves, illegal drugs aren't hard to come by anyway.
    Let the masses drown in opioids of their own choosing instead or benzodiazepines.

    Just my opinion.
  3. scartissue_68
    I wonder how many of these overdoses are actually due to prescribed opiate pills.

    Illegal pills are now being laced with Fentanyl. How do we know that what was reported as Hydrocodone wasn't Fent?

    I've said this before, but it is no surprise that the DEA got unintended consequences when throwing Hydro into Schedule II. Example: A patient is cut off by their doctor due to the hysteria as described in BT2H's post, but wants more Hydrocodone, so he/she seeks it out on the black market. Now, they might get real Hydro at an extreme price, bargain priced Hydro (actually Fentanyl) that was made in a basement lab and of course, the street dealer also has Heroin.

    If all prescription opiates were cut off tomorrow, many patients would find a black market alternative and OD deaths would skyrocket.

    I almost agree with DeToxin 8's last sentence.
  4. AKA_freckles
    DT8 - Oh I'm all for legalizing drugs, and to expand on my comment I mean that Purdue ruined the whole thing. Purdue is why you can't get necessary prescriptions now. Why doctors are so scared to write for anything controlled. They blew the opiate prescriptions through the roof for huge profits, only to have this rebound effect. If you're mad, they're a good place to start when looking for somewhere to direct your anger.

    On another note, I do agree with the article that alternate pain treatments should absolutely be covered by insurance, but as far as things like acupuncture the only insurance that covers it here is Kaiser, and only their own practitioners. And I think most insurance would require a high level medical degree (PA or NP or higher) to administer it, which I think would be hard to come by.

    Just as an aside, I had 3 home births, saving my insurance somewhere in the range of $60,000 dollars and they wouldn't even pay $2,000 a pop after all was said and done with no complications. They should have sent me flowers and a thank you note. And my midwives were an RN and a PA respectively.

    Craziness abounds in the insurance world. I guess they would rather cover generic pills that are dirt cheap rather than other treatments that would require considerably more upfront but would save tons of money in the long run.
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