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article imageDoctors concerned about addiction prescribing fewer opiates

By Matthew DeLuca     Dec 9, 2014 in Health
According to a new study released by the Johns Hopkins Bloomberg School of Public Health, nearly half of all primary care physicians in the U.S. say they are becoming less likely to prescribe opioids to patients for pain management.
This comes amidst a growing recognition among doctors that prescription opiate addiction is a problem.
According to the study led by Dr. G. Caleb Alexander, associate professor of epidemiology at the School of Public Health and co-director of Johns Hopkins' Center for Drug Safety and Effectiveness, ninety percent of the physicians identified prescription drug abuse as a moderate or big problem in their communities, and in many communities across the United States, prescription drug abuse is truly — a big problem.
According to a 2011 National Institute of Drug Abuse (NIDA) report on prescription drug abuse, in 2010 8.76 million people abused prescription drugs. Deaths from drug overdose now surpass traffic fatalities and prescription drug deaths now exceed deaths from all other illegal drugs combined.
Alexander states, "Our findings suggest that primary care providers have become aware of the scope of the prescription opioid crisis and are responding in ways that are important, including reducing their over-reliance on these medicines." The study, shows that 85 percent of responding physicians believe that “opioids are overused in clinical practice.”
According to data from NIDA, in 2010 enough prescription painkillers were prescribed to medicate every adult American every four hours for one month, and in 2013, 207 million prescriptions were written for prescription opioid pain medications. Since 1990, prescriptions for opioid medications have greatly increased and in this time drug overdose deaths have also increased with rates more than tripling since 1990, according to the CDC.
According to additional CDC data, in 2012, of the 41,502 drug overdose deaths recorded in the U.S. 53 percent were associated with prescription medications. Of these 22,114 deaths associated with prescription drug overdose, 72 percent involved opiates of some kind.
Among their primary concerns, 55 percent of responding physicians reported that they were “very concerned” about addiction and 48 percent reported that they were “very concerned” about overdose death.
Many physicians also worried that opiate use could have other adverse effects. Fifty-six percent of physicians reported that opiate use “often” leads to physical dependence, even when used as directed and not abused. This leads to the added concern that opiate users may end up using heroin as a less expensive alternative or when prescription drugs become unavailable.
Although doctors reported these concerns about prescribing opiates and say they are less likely to prescribe these drugs because of concerns about drug addiction, 88 percent of responding physicians reported that they were confident in their own ability to appropriately prescribe opiates for pain management.
Dr. Alexander, however, hopes that physicians will begin to look toward treatments that do not involve opiate prescriptions. This could include substituting opiates with other, less-dangerous pain relievers or resorting to non-drug treatments such as physical therapy, massage or acupuncture, and with the mounting concerns about opiate addiction in the medical community revealed by the study, it appears physicians agree.
"The healthcare community has long been part of the problem, and now they appear to be part of the solution to this complex epidemic," says Alexander. Although more research is needed, including compiling pharmacy data on opiate prescriptions to confirm the degree to which doctor’s growing concerns about opiate addiction are reflected in their prescribing practices, the insights into physicians attitudes that can be gleaned from this study will certainly be valuable in addressing the issue of prescription drug abuse and the medical communities reliance on opioid medications.
More about Prescription drugs, Prescription, Prescription drug abuse, Prescription pills, Oxycontin
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