Wednesday, March 7, 2018

Politicians Cannot Stop Punishing Patients for the Unintended Consequences of Drug Prohibition

It seems no amount of evidence can make political leaders disabuse themselves of the misguided notion that the nation's opioid overdose crisis is caused by doctors getting patients hooked on prescription opioids.

It would impose a 3-day limit on all opioid prescribing for patients in acute and outpatient postoperative pain.

The politicians base their proposal on the 2016 opioid guidelines put out by the Centers for Disease Control and Prevention.

It doesn't seem to matter that studies have shown the addiction potential of opioids prescribed for acute pain to be extremely low, including a January 2018 study published in BMJ of more than 568,000 postoperative patients receiving opioids between 2008 and 2016 who were found to have a "Misuse" rate of 0.6%. It doesn't matter that Cochrane systematic studies in 2010 and 2012 demonstrated a roughly 1% addiction rate in chronic non-cancer pain patients.

The National Survey on Drug Use and Health reports that less than 25% of nonmedical opioid users received a doctor's prescription, and a November 2017 study found that heroin was the gateway drug in 33.3% of opioid addicts entering rehab in 2015.

With the advent of abuse-deterrent prescription opioids in 2010, opioids diverted to the black market have become increasingly useless to nonmedical users.

As a surgeon who prescribes postoperative opioids to my patients for pain control, I will no longer be able to individualize my prescriptions to my patients.

https://www.cato.org/blog/politicians-cannot-stop-punishing-patients-unintended-consequences-drug-prohibition

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