Are Prescription Opioids Driving the Opioid Crisis? Assumptions vs Facts
| Autor: | Mark Edmund Rose |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Prescription Drugs Substance-Related Disorders Overdose Analgesic Review Article Risk Assessment Fentanyl Heroin 03 medical and health sciences 0302 clinical medicine medicine Humans 030212 general & internal medicine Medical prescription Intensive care medicine business.industry Chronic pain Opioid overdose General Medicine Opioid-Related Disorders medicine.disease OPIOIDS & SUBSTANCE USE DISORDERS SECTION Opioids Analgesics Opioid Prescribing Prescriptions Anesthesiology and Pain Medicine Opioid Neurology (clinical) Chronic Pain Safety Drug Overdose business 030217 neurology & neurosurgery medicine.drug Medical literature |
| Zdroj: | Pain Medicine: The Official Journal of the American Academy of Pain Medicine |
| ISSN: | 1526-4637 1526-2375 |
| DOI: | 10.1093/pm/pnx048 |
| Popis: | Objective Sharp increases in opioid prescriptions, and associated increases in overdose deaths in the 2000s, evoked widespread calls to change perceptions of opioid analgesics. Medical literature discussions of opioid analgesics began emphasizing patient and public health hazards. Repetitive exposure to this information may influence physician assumptions. While highly consequential to patients with pain whose function and quality of life may benefit from opioid analgesics, current assumptions about prescription opioid analgesics, including their role in the ongoing opioid overdose epidemic, have not been scrutinized. Methods Information was obtained by searching PubMed, governmental agency websites, and conference proceedings. Results Opioid analgesic prescribing and associated overdose deaths both peaked around 2011 and are in long-term decline; the sharp overdose increase recorded in 2014 was driven by illicit fentanyl and heroin. Nonmethadone prescription opioid analgesic deaths, in the absence of co-ingested benzodiazepines, alcohol, or other central nervous system/respiratory depressants, are infrequent. Within five years of initial prescription opioid misuse, 3.6% initiate heroin use. The United States consumes 80% of the world opioid supply, but opioid access is nonexistent for 80% and severely restricted for 4.1% of the global population. Conclusions Many current assumptions about opioid analgesics are ill-founded. Illicit fentanyl and heroin, not opioid prescribing, now fuel the current opioid overdose epidemic. National discussion has often neglected the potentially devastating effects of uncontrolled chronic pain. Opioid analgesic prescribing and related overdoses are in decline, at great cost to patients with pain who have benefited or may benefit from, but cannot access, opioid analgesic therapy. |
| Databáze: | OpenAIRE |
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