Doctors And Dentists Still Flooding U.S. With Opioid Prescriptions

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Doctors And Dentists Still Flooding U.S. With Opioid Prescriptions​

July 17, 2020

Despite widespread devastation caused by America’s opioid epidemic, an investigation by NPR found that doctors and other health care providers still prescribe highly addictive pain medications at rates widely considered unsafe.

Public data, including new government studies and reports in medical literature, shows enough prescriptions are being written each year for half of all Americans to have one.

Patients still receive more than twice the volume of opioids considered normal before the prescribing boom began in the late 1990s.
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See the rest at link.

This is a problem that needs to be confronted.
 
Here in Texas we are addressing this with the PMPAWARE system whereby all physicians and dentists must check each patient’s prescription history before prescribing a narcotic. This is to catch patients who are hopping around to different HCPs and getting multiple scripts for opiods. It also holds HCPs accountable to over prescribing opiods. We are also required to perform a self-audit every year.
 
Just to play Devils Advocate, we’re seeing the same dynamic with opioids that we saw a couple decades earlier with antibiotics.

Patients come in, they already know what they want, and they nag until they get it.

Which is why I fully support the registries where the doctors and pharmacists are all in a database and can see who is being prescribed opioids, in what dosages and quantities and for how long.
 
We have the database in our state. And it is used by doctors as well as the pharmacies that fill the prescriptions.

I think the demonizing of all doctors needs to stop. Most doctors won’t even prescribe opioids in my area. And yet they are thrown into a “group of evildoers.” The ones that do are in pain management and their patients need stronger prescriptions than most.

One thing that people conveniently leave out of the equation is that if taken as prescribed, by the person they are prescribed for there is usually not a problem.

And for those that say people have become addicted, most of them were not prescribed for them and they are abusing them in the same way that addicts of other drugs abuse them. They need to take responsibility for their addictions and get help, not blame doctors.
 
I shadowed a dentist years back. The secretary in the office said you get really good at figuring out who is drug seeking… every Friday afternoon…
 
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I think this can cut both ways. I think you bring up a really good point regarding personal responsibility. However I’ve also heard of quite large prescriptions written for a relatively minor procedure where a three day run would probably be sufficient. So I think awareness and responsibility needs to be used all around.
 
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How about we trust doctors to treat patients. Opioid pain meds are an important tool, making doctors afraid to prescribe, making those with serious pain feel like criminals, is nanny state.
 
Exactly. Doctors have to become detectives to assess which patients are drug seeking and which ones have legitimate chronic pain. @TheLittleLady, I agree that chronic pain patients are accused of have addiction problems, or are encouraged by their insurance provider to use less helpful and cheaper medicines, under the guise of “helping to end the opioid crisis.”
 
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I agree totally. I suffer from both nerve and arthritic pain and always keep an opioid nearby. It has gotten more difficult to get the prescription I need because of the pressure being put on doctors by people who think they’re doing good. I’ve been on an opioid since 2006, am not addicted and use them responsibly. Most of us do.
 
Agreed that sometimes prescribing something too strong happens. My son got something for pain In his hip that I thought was over the top. I told him to only take it to go to sleep and not on a regular basis.
 
Irishmom2 said:
encouraged by their insurance provider to use less helpful and cheaper medicines, under the guise of “helping to end the opioid crisis.”
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Completely agree. I think providers are often under a lot of undue external pressures. I think it often becomes easier or simply less litigious to use the prescription pad. However that’s often due to increased productivity requirements and reactive care from financial/insurance pressures. Not to mention patients can be unrealistic on occasion. I think everyone taking a good look at themselves is often a good first step.
 
If there is no clinical cause of pain, the doc refuses.

However, if doc is not treating pain, the patient needs to find a new doctor. Chronic pain, acute pain, are real.
 
Some are learning. I recently went to the dentist and he told me that for most procedures he has replaced opioids with a protocol that uses a combination of ibuprofen, tylenol and caffeine. I took it and it worked really well, without any noticeable side effects or chance of addiction. Five years ago he would have probably given me some kind of opioid. We need to get more doctors and dentists on board, but at least some are listening.
 
This Tylenol-Ibuprofen protocol developed by a professor at my dental school (Dr. Hargreaves) is useful for weekend emergencies, but it is not meant for long-term pain management. The reason it is not intended for long term utilization is it prescribes using both medications at their maximum allowable dosages. If someone has liver or kidney issues, it should absolutely be avoided. But even if a healthy person uses it long term, it can start to have negative effects on the liver and kidneys. As always, consult with your physician on any change in medications.
 
As a chronic pain patient, I’m very much in tune with what’s happening in regards to opiates. The problem needs to be addressed on several fronts. Over prescription by doctors has been greatly reigned in, in the last several years.

The flood of opiates in the streets are not due to prescribing doctors…or very little. It’s due to fake research labs set up that then have the ability to order large quantities from overseas. These then ecome the street drugs available.

Patients on pain management therapy are watched and monitored like hawks. The process for getting your prescription and then filling it has become cumbersome…especially for someone that is already in chronic pain. Each prescription must be picked up in person and physically signed by the doctor…no electronic filling allowed.

We need to address the horrible addiction problems of those abusing the drugs but we must also keep in mind the thousands of chronic pain patients that absolutely need these drugs for any quality of life. I don’t mind having to jump through some reasonable hoops to keep these meds away from addicts. I don’t mind having to sign a pain contract yearly. I don’t mind being restricted to one pharmacy only to fill my Rx as long as I still get to choose which one.

The problem isn’t the doctors…sure there are a few that abuse the system…there is in any system…but it’s no longer the doctors in general overprescribing. It’s addicts gaming the system and the street availability due to sham research labs. Focus where the problem is not where the problem isn’t!
 
The doctors are not to blame for the crisis. The people abusing opioids are.
 
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