Most people would be a little alarmed to hear about the high likelihood that is involved when it comes to being addicted to prescription opiates. But there is, in fact, a large correlation between the doctor that treats you, and your likelihood of becoming addicted to prescription painkillers.
Harvard school of public health have reasonably recently released a study that looked at the prevalence of prescription opiate addiction among doctors who prescribed them at different amounts. The results were quite shocking, to say the least.
Harvard school of public health found that if you have a doctor that prescribes opiates more than average, you are more than 30% more likely to use the opiates for 6 months longer (compared to an average doctor).
The study also looked at the rate at which doctors prescribed opiates to their patients. There was a sizable difference between the most prescribing doctors and the least prescribing ones. The highest prescribing rates were quite shocking, to say the least. The most prolific prescribers gave opiate pain relief to 24% of patients on average. The most restrained doctors however only gave them out around 7% of the time.
The amount of pain relief you are given in the A&E room when you are first treated also has a significant correlation with your likelihood to become addicted (according to the study). If you were given a large dose of opiate pain relief in the hospital, you are much more likely to become addicted when you have been discharged.
This over prescribing issue is claimed to be present because of a lack of training that is given to doctors. Doctors claim they are not instructed or taught on how to prescribe opiates in proper amounts, or on when they could be substituted for other pain killers.
Since the year 2000, there have been over 180,000 deaths due to abuse of prescription opiates – and it’s quite hard to figure out who to blame. The most common (and easy) target is the doctors themselves. They are seen to be the ones that are handing out these powerful medications without proper safe guards.
If this is a fair accusation or not depends on who you ask. The study done by Harvard school of public health does have a few inconsistencies which make it less than air tight evidence. The main issue being that the study was not done in a controlled manner, and looked at over 380,000 Medicare patients that walked into multiple emergency rooms across the country.
However, despite it not being a controlled piece of research, it is hard to dismiss due to the very strong correlation it identified (and due to the size of the study).
Doctors claim that they cannot be held responsible for improper opiate prescriptions. There does not seem to be a standardized methodology for prescription, and the doctors are left to use their own intuition. This could easily explain the different prescription rates between different doctors, even if they are working in the same hospital.
It should be mentioned that this study is studying long term use of opiate pain killers, and is not studying opioids addiction – which is a very different thing. Many long term users of opiates go on to live normal lives without ever becoming addicted, but some people are not so lucky.
As a result of this study (and other factors), the CDC has decided to release a recommendation that doctors heavily limit their opiate prescriptions. They are being advised to prescribe the lowest possible dosage, for the minimal amount of time. It is thought that this will reduce the prevalence of prescription opiate addiction which is currently ravaging our society. When drug and alcohol rehab centers are being filled by doctors, it’ time for something to be done about it.
There have been several studies and national polls conducted on this topic, and one of the most interesting ones was released by the Washington Post and the Kaiser Family Foundation. They looked for people who had been prescribed opiate pain killers for more than three months and asked them about their usage. They found that over 30% of the people they contacted had become addicted, or at least dependent upon the medication.
The most worrying question however around this whole issue is related to patient after care. The majority of patients who are prescribed opiate painkillers will have to attend a follow-up appointment with their doctor at some point.
So why are they not being denied their prescription when they no longer need the medication?
The answer is surprisingly simple, and very human. Doctors are reluctant to take away a medication that patients are happy with. If they are currently in no pain because of the medication it’s very difficult to tell a patient “Sorry, you need to deal with the pain now – it’s for your own good”.
So while it is quite worrying to have to say this, the public needs to be aware of the potential issues caused by prescription opiate addiction. If you are prescribed opiates by your doctor, ask them if there is an alternative (less addictive) painkiller that could be prescribed instead.
Sometimes the doctor will advise that it’s the only thing that will work well enough.
When this happens you should always take their advice, they are far more qualified to recommend a medication than any article like this on the internet. But be aware of the potential addictive qualities, ask for smaller doses, and try to stop using the medication as quickly as possible.
Now we know that many people will read this article and think it will never happen to them. This kind of thing happens to other people, right?
Well, unfortunately, no, it doesn’t. Anyone can have an accident that requires a trip to A&E and prescription pain killers. Some of the worlds strongest and brightest minds have succumbed to prescription opiate addiction and ended up in drug detox centers. Successful careers have been ruined, marriages have ended, and wholesome lives have been destroyed because of medication prescribed to them by a doctor.
And if it can happen to them, it can happen to you too.
Dr. Vikram Tarugu, M.D, is the CEO of Detox of South Florida, Inc and medical professional focused on addiction. A veteran in the medical field with over 25 years of professional experience. He is a consultant for many South Florida Rehab centers. Patients travel from allover the US to seek his help with addiction and Hepatitis C treatment.
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