Recognizing the Risks of Prescription Painkillers

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Last week, the Food and Drug Administration (FDA) announced that it will require labeling changes for some of the most commonly used prescription pain medications in response to rapidly rising rates of misuse and overdose. This well-timed announcement will hopefully draw extra attention to what the FDA labeled a “crisis” during a month that is both National Alcohol & Drug Addiction Recovery Month and Pain Awareness Month.

Prescription drug abuse poses a bigger threat to American health than you might realize. It now kills more Americans than car accidents, firearms and both heroin and cocaine. And rates of overdose appear to be increasing. Over the past 14 years, the number of people dying from prescription drug abuse has quadrupled.

The FDA’s new required language will specify that extended-release and long-acting opioid painkillers (such as certain formulations of oxycodone, hydromorphone, fentanyl and morphine) should be used only when pain is so severe that it requires “daily, around-the-clock” pain control. New labels will also state that these medications should only be provided to patients who cannot use other pain-control treatment options. Additionally, the FDA will require producers of these painkillers to conduct more studies into the effects of long-term opiate use.

The government organization hopes that these changes will encourage more thoughtful prescribing and increase patient awareness of the risks of taking these potentially addictive pills. However, the new language will not restrict access to these medications, which also provide necessary pain relief for cancer patients and many people who do not benefit from alternative treatments.

Even though prescriptions of opiate pain medications have skyrocketed, there is little evidence to suggest that their increased use has significantly improved pain treatment. In fact, a new study published this month suggests that the use of safer alternatives to opiate painkillers has plateaued or even dropped — even though in many cases opiates are not more effective at treating pain than non-opiate alternatives. The study’s authors suggest that doctors’ over-reliance on opiate pain medications may be interfering with improvement of pain detection and treatment.

There is even evidence that long-term use of opiate pain medications may actually worsen pain. A recent study showed that long-term use of codeine, which is one of the most commonly used opiate pain medications, may make people more sensitive to pain.

When you look at prescribing habits, it’s not so surprising that opiate addiction has become such a widespread problem. In 2010 there were 164 million doctor’s visits for pain. Nearly half of people who saw their doctors for a pain-related complaint were treated with a pain medication, and 20% received an opiate. You don’t have to do the math to realize that doctors’ prescribing habits are contributing to the addiction epidemic.

Nearly 100 million Americans live with chronic pain. Finding an acceptable treatment that will allow them to enjoy their lives is critical. But both patients and doctors need to work together to limit opiate use to those who really need it, and stem the tide of misuse that is threatening the lives and well-being of millions of Americans and their families.