For the first time in history, the Centers for Disease Control and Prevention (CDC) has issued guidelines for prescribing opioids. According to a recent study from the National Safety Council, 99 percent of doctors overprescribe opioids. Some common opioids include OxyContin, Vicodin and Percocet.
In order to combat this epidemic, the CDC is using a new tactic. It is developing guidelines and advising prescribers. The new guidelines are complex, but they recommend when — and when not — to prescribe opioids for chronic pain, the proper dosages and how to assess risk of abuse.
As a student, I have spoken to many doctors and have seen the different ways in which they prescribe medication. I have seen the need for these guidelines firsthand.
Of course, I don't claim to know more than the doctors in the slightest. But I do have friends and family members who have fallen victim to prescription pill addiction. As a result, I have come to know the signs of opioid abuse, which many clinicians who don't have similar experiences may fail to recognize. And while I never witnessed misconduct, I have noticed clinicians who are more "conservative" and those who are more "liberal" in their prescriptions.
There is another group of individuals who make the same observation: drug seekers. These individuals “doctor shop” to find doctors who will prescribe painkillers. They fabricate symptoms, invent injuries, deny receiving prescriptions from other physicians and often lie about lost or stolen pills. If clinicians are unwilling to prescribe, they can become aggressive, write poor online reviews or respond negatively to patient satisfaction surveys that affect government reimbursements.
This, of course, leaves prescribers in a tough position having to determine whether a person's pain truly is what they say it is, while weighing the risks and benefits of writing a script. This leaves drug seekers in an even more dire situation because when they can no longer find willing doctors – many turn to heroin.
When I see these patients, I sympathize. They bring back visions of the desperation and despair I saw in my loved ones addicted to painkillers. Unsuspecting, innocent, kind-hearted people who became addicted – to very addictive drugs. I want to tell them that they can stop the search. I want to tell them that help is available. I want to tell them that I understand.
Because contrary to popular belief, becoming an opioid addict doesn't require an “addictive personality,” poor coping skills, mental illness, weakness, familial predisposition or trauma. These drugs physically change the way nerve cells work in the brain, subjecting many unwary victims to the rapacious predator of addiction. As a society, we have a tendency to look down on addicts, when sometimes the very source was just a prolonged opioid prescription, not a moral failing.
The CDC's guidelines are designed to break this progression by reducing the number of individuals who are introduced to opioids in the first place, ultimately reducing the overall rates of drug abuse and addiction. This will also help decrease the number of pills in circulation that can be stolen or purchased on the black market.
Sure, these guidelines are just that: guidelines. But at least one hospital is already taking action by substituting nitrous oxide (aka laughing gas), acupuncture, physical therapy and nerve blocking to help manage pain. I am hopeful that many more hospitals and primary care practices will follow suit and reserve opioids only for when they are truly necessary.
While the CDC cannot curtail doctors' ability to prescribe medication, these guidelines will raise awareness of this problem and can help reverse this epidemic.