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Opioids might have serious side effects and led to tolerance and dependence
For years, the ‘pills mills’ – clinics that used to handle opioid drugs to anyone who asked for them, have been blamed for the increased rate of opioids abuse. But a new study shows that all doctors are to be blamed for overprescription of opioids.
According to a study from 2011, about one third of opioid prescriptions in the United States were prescribed by one percent of prescribers and 80 percent were prescribed by about 10 percent of prescribers.
Starting that year, efforts have been made to reduce the number of opioids, even by passing laws aiming to shut down the pills mills.
However, a study released earlier this year, which analyzed the effects of such a law in Florida has shown that the closing of the pills mills produced a very small decrease in opioids prescription, of less than 2 percent.
The new study published by Stanford researchers in the American Medical Association Journal shows that the pill mills are not the only responsible for the overprescription of opioids so going after them is not enough.
Dr Jonathan Chen, one of the authors of the study and a physician, claims that it is very hard to make the decision whether to prescribe opioids to someone with chronic pain and who also developed a substance-dependence.
Analyzing over 56.5 million claims for prescriptions in 2013, covered by 381,575 prescribers of all Schedule 2 opioids such as hydrocodone (Vicodin), oxycodone (Oxycodin, Percocet) and codeine, researchers at Stanford discovered that even after the closing of the pill mills, some practitioners were still prescribing an astonishing amount of opioid pain killers.
About 57 percent of prescriptions were prescribed by ten percent of prescribers. Most of the prescribers are internal medicine practitioners, family practitioners, physician assistants and nurse practitioners.
Family practitioners were responsible for 15.3 million prescriptions; internal medicine practitioners for 12.8 million; nurse practitioners issued 4.1 million prescriptions and physician assistants 3.1 million.
The abuse of narcotic painkillers has increased with 10 percent over the last 20 years. Authors of the study suggest that all the practitioners should be educated on the risks of prescribing opioid painkillers. Doctors should be aware and look for alternative treatments of pain when they are available. Opioids should be the last resort for patients suffering of chronic and acute pain.
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