Opioids, A Second Look
InBrief
by Christopher King, NP
At the beginning of June 2019, I attended the International Conference on Opioids (ICOO) held at Harvard Medical School in Boston, Massachusetts. I believed that I was fairly well informed about the opioid crisis in this country, and I hoped to learn enough to give chronic-pain patients better rationales for denying opioid prescriptions. I was sure that information shared at the conference would support two important positions: some of these drugs often are not indicated for chronic pain, and overprescribing may have dire consequences. However, information shared during some of the presentations made me question the rigidity of my beliefs.
The scope of the problem is immense. From 1990-2012, opioid prescriptions in the United States increased from under 1 million to over 255 million. ...
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ABOUT THE AUTHOR
Christopher King, NP
Christopher's nursing experience after undergrad was primarily working in Emergency medicine in Central and Coastal Maine. In 2014 Christopher went back to school for his Master's Degree and graduated in 2016 from the University of Southern Maine with his MSN. Currently Christopher works for New England Sport and Spine in Manchester ME. When not working Christopher enjoys the Maine outdoors with his wife, children and 2 dogs.Â
Sources
Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention. US Opioid Prescribing Rate Maps. CDC Web site. https://www.cdc.gov/drugoverdose/maps/rxrate-maps.html. October 3, 2018. Accessed July 2, 2019.
Dahlhamer J, Lucas J, Zelaya C, et al. Prevalence of chronic pain and high-impact chronic pain among adults - United States, 2016. MMWR Morb Mortal Wkly Rep. 2018;14;67:1001-1006.
Dowell D, Haegerich TM, Chou R. CDC Guideline for Prescribing Opioids for Chronic Pain—United States, 2016. CDC Web site. www.cdc.gov March 18, 2016. Accessed July 2, 2019.
Dowell D, Haegerich T, Chou R. Perspective: No shortcuts to safer opioid prescribing. N Engl J Med. 2019;380:2285-2287.
Rosenblum A, Marsch LA, Joseph H, Portenoy RK. Opioids and the treatment of chronic pain: controversies, current status, and future directions. Exp Clin Psychopharmacol. 2008;16:405–416.
Schatman ME, Peppin JF, Fudin J. The CDC guideline: the three amigos wade into the fray. Presented at: International Conference on Opioids; June 9, 2019; Boston, Massachusetts. http://opioidconference.org/uploads/1_8_3_FUDIN_The_Three_Amigos_Wade_into_the_Fray.pdf. Accessed July 2, 2019.
US Food and Drug Administration (FDA). FDA identifies harm reported from sudden discontinuation of opioid pain medicines and requires label changes to guide prescribers on gradual, individualized tapering. FDA Web site.
https://www.fda.gov/drugs/drug-safety-and-availability/fda-identifies-harm-reported-sudden-discontinuation-opioid-pain-medicines-and-requires-label-changes. April 9, 2019. Accessed July 2, 2019.
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