Physicians Continue to Prescribe After Opioid Overdose

by Beth Tesmond, MHS, CADC, MISA, Addictions Program Coordinator

Abuse of control prescription drugs now exceeds abuse of all illegal drugs combined, except marijuana. Many of those in the addiction field believe that oxycontin is at the very heart of the vast opioid drug addiction epidemic currently seen in the United States. Not only is it highly addictive, but it is vastly over prescribed.

Therefore, it is no wonder that clinical experts, congressional leaders and patient advocates throughout the country were outraged when the Food and Drug Administration (FDA) approved the use of oxycontin (oxycodone) in children, age 11 to 17 in 2015.

Regrettably, the news regarding opioids only continues to worsen.

According to research published in the journal Annals of Internal Medicine, more than 90% of patients with chronic pain continue to receive prescription opioids after an overdose, putting them at high risk for a future overdose.

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Since 1999, the number of unintentional overdose deaths from prescription pain relievers in the US has more than quadrupled. Additionally, there is growing evidence that an escalation in nonmedical use of opioid analgesics is linked to heroin abuse throughout our country.

One would think that if a patient had a near-opioid overdose, it would serve as a huge red flag as well as an opportunity to identify and treat a substance use disorder; evidently, that was not necessarily the case.

Researchers utilized information from Optum, a national commercial insurance claims database with data on 50 million individuals over a 12-year period, to identify nearly 3,000 patients who experienced a nonfatal overdose while taking opioids. These drugs were prescribed for chronic pain.  Following the overdose, a full 91 percent of overdose patients continue to receive the same drugs and 70% of patients received prescriptions from the same provider who prescribed the opioids before their initial overdose.

Two years later, patients who continued taking high dosages of opioids were twice as likely to have another overdose, compared with those who stopped using opioids after the overdose.

Opioids are extremely important medicines. They are profoundly beneficial in end-of-life care and when used short-term after surgery. However, when these drugs are prescribed long-term, to say nothing of refilled after overdose, that is just bad medicine.

 

 

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