Opioid Scripts Too Robust, Danger Dependancy

Opioid Scripts Too Strong, Risk Addiction

It's been in the news for years: Opioids are addicting even when prescribed for legitimate reasons. However, a new study shows that even with a relatively simple operation, the pain relieving power conferred in a script is still there. There is the potential for addiction.

In the 1990s, when doctors started prescribing opioids to help their patients manage pain, they were still unaware of how addictive these drugs were. It is estimated that more than 2 million Americans today are dependent on prescription opioids or heroin, often the drug of choice for people who cannot take opioids. And according to the latest published figures from the National Institute on Drug Abuse, 128 people die from opioid overdoses in the US every day. More than three quarters of a million people have died since 1999. Despite efforts to reduce prescription opioid use, not all doctors appear to be on board the plan.

New research from the University of Pennsylvania looked at nearly 100,000 patients who had knee surgery between January 2015 and June 2019. They focused on patients who had never used opiates before. Some of these patients had a procedure that cut the bone while others only involved tissue and muscle.

The researchers found that opioid prescription rates for these patients varied widely across the country, with the lowest being 40% in South Dakota and the highest being 85% in Nebraska. What all states had in common, however, was that the median prescription strength was too high, placing patients at risk of overdose. The patients received an average of 40 tablets, but some more than 100. "… [D] The average number of tablets prescribed was extremely high for outpatient procedures of this type, especially in patients who had not taken opioids before surgery," said Dr . M. Kit Delgado in a press release. Dr. Delgado is a study co-author and assistant professor of Emergency Medicine and Epidemiology at the Perelman School of Medicine in Penn.

These patients not only received lots of pills after their knee surgery, but also received heavy doses. The study showed that many patients were given a daily dose above the addiction threshold of the Centers for Disease Control and Prevention. "Patients prescribed higher doses of opioids are at greater risk of death from overdose," said the CDC.

It is not uncommon for patients to have prescription opioids left over, on average they never use more than half. Just because these pills are not taken as prescribed does not mean they will not be used. Researchers surveying teenagers taking prescription opioids found that more than a third of them were using pills left over from their own prescriptions, half were given pills from a friend or family member, and a fifth were taking pills from a friend and a family member.

The Penn study suggests that there might be better guidelines for prescribing pain medication. While it is important that postoperative patients feel comfortable, it should be possible to do so without increasing the risk of addiction. "… Despite recent attention to the management of opioids, we find evidence of significant differences in the practice of prescribing opioids for the most common outpatient procedure and plenty of room for improvement," said Dr. Delgado in a tweet.


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