Drugs

Despite Opioid Crisis, Too Many Prescriptions Still Given Out

It’s been in the news for years now, opioids are addictive, even when given for legitimate reasons. News stories across the country have shown an average mom, dad, son or daughter who took the pain killers after a medical or dental procedure, only to quickly become addicted. And yet, the prescriptions continue.

In the 1990s, when doctors began to prescribe the opioids to help their patients manage their pain, they weren’t yet aware how addictive these drugs were. But now, it’s estimated that more than 2 million Americans are addicted to prescription opioids or heroin, often the drug of choice for people who can no longer get hold of opioids. And, according to the latest published numbers by National Institute on Drug Abuse, 128 people in the United States die every day from an opioid overdose; more than three-quarters of a million people died since 1999. In the face of these alarming numbers, there are pushes to reduce prescription opioid use, but not all physicians are following through.

New research from the University of Pennsylvania looked at nearly 100,000 patients who had knee surgery between January 2015 to June 2019, well after the first alarms sounded regarding opioid use. The researchers focused on patients who had never taken opioids before. Some of these patients had a procedure that involved cutting bone, for others the surgery was less invasive, affecting just tissue and muscle.

The researchers found that there was a lot of variation in the opioid prescription rates across the country for these patients, with the lowest at 40% in South Dakota and the highest at 85% in Nebraska. But what the states all had in common was the average prescription strength was too high, which puts them at risk for overdoses. “... [T]he average number of pills prescribed was extremely high for outpatient procedures of this type, particularly for patients who had not been taking opioids prior to surgery,” M. Kit Delgado, MD, said in a press release. Dr. Delgado is one of the authors on the study and an assistant professor of Emergency Medicine and Epidemiology in the Perelman School of Medicine at the University of Pennsylvania.

Additionally, many patients were given more pills for longer than recommended. The stronger the prescription and the longer it lasts, the more patients are put at risk of addiction. If that’s not enough of a problem, consider the unused pills and what happens to them. On average over half are never taken. This leads to the possibility of the pills be misused or sold.

This study suggests that there could be better guidelines for prescribing pain medication. It is important to keep post-operative patients comfortable, but that should be possible without increasing the risk of addiction. “Despite recent attention to opioid stewardship, we find evidence of significant practice variation in opioid prescribing for the most common outpatient procedure and ample opportunity for improvement,” said Dr. Delgado in a tweet.

 

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