HealthMarch 14, 2018

Tackling opioid abuse starts with evidence-based prescription decisions

Individuals, families, and employers in every region of America are grappling with the effects of prescription opioid addiction. The crisis doesn’t appear to be winding down. Physicians and pharmacists must redouble their efforts to help curb the social toll from prescription abuse.

Overdose deaths from prescription opioids were five times higher in 2016 than 1999, and sales of the drugs quadrupled in that period. Between 1999 and 2016, more than 200,000 people died in the US from overdoses related to prescription opioids. In 2016, 46 people died every day from overdoses. The CDC reports that opioid prescribing continues to fuel the epidemic.

Prescribing norms and expectations for opioids are changing, and they will do so faster if the recommendations in a recent federal study are implemented. In a report unveiled Nov. 1, 2017, the President’s Commission on Combating Drug Addiction and the Opioid Crisis suggested that physicians and medical education and continuing education institutions all have a role to play in curbing this epidemic.

It can be confusing for doctors to try to discern which of their patients are presenting with genuine severe pain that may justify the prescribing of powerful opiate-based painkillers, and which are at risk of abusing prescribed medication. The bewilderment that physicians can face in front of such patients is painfully detailed by Siddhartha Mukherjee, MD, in a recent New York Times essay describing his interactions with a patient insistent on obtaining Vicodin®, Percocet®, and oxycodone. As a young physician in 2001, when these events took place, Mukherjee was stumped by his patient’s behavior and lack of cooperation. Today, he notes, young doctors have much more training in how to detect drug abuse and avoid writing prescriptions that contribute to addiction.

The proposals from the President’s Commission include:

  • A national curriculum and standard of care for opioid prescribers
  • New informed consent protocols before patients get an opioid prescription for pain.
  • A model training program for medical education
  • Required Continuing Medical Education for opioid prescribing
  • Training for pharmacists to recognize illegitimate opioid prescriptions

Medical professionals wanting to educate themselves on the current standard of prescribing for pain can find a wealth of information on these drugs and their properties in our Clinical Effectiveness solutions. Medical practices and accountable care organizations can equip their physicians with evidence-based information and graded recommendations from UpToDate®, educate their patients on the risks of becoming addicted to opioids with Emmi, and use drug leaflets from Lexicomp®.

To view select Emmi programs designed to help patients understand how opioids work, what they should be used for, and what dangers they may present, go to and use the code: Opioid18. For more information on how Emmi can help you prepare your patient population, contact us.

This is part one of a three-blog-post series on current best practices in pain management with opioid medication.


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