Medical Community Tries To Slow Flood of Painkiller Misuse
The Denver Post
Deaths linked to prescription opioid use
have doubled in 10 years in Colorado, and the steep increases in both
legal use and dangerous abuse of painkillers are forcing the medical
community to rethink the way it treats chronic pain.
Painkiller
prescriptions written by the top 10 Medicaid prescribers for one popular
drug, Roxicodone, shot up 46 percent last year, according to state
records. Denver's Office of Drug Strategy found that prescriptions
filled for oxycodone rose 58 percent from 2007 to 2011.
Nonmedical use of painkillers in Colorado is 19 percent higher
than the national average, according to the Centers for Disease Control
and Prevention. To illustrate the "epidemic" nature of opioid abuse,
the CDC said
h of the painkillers were sold in 2010 to
medicate every American adult with a typical 5-milligram dose of
hydrocodone every four hours for a month."People think, 'It's a
pharmaceutical, it's pure, it's good for me.' That lends itself to a
casualness about the use of it," said Art Schut, deputy director of the
Arapahoe House addiction-treatment center in Thornton. Patients learn
too late that opioids are severely addictive, in part because of their
ability to both block pain and induce euphoria.
The number of
Arapahoe clients coming in for opioid dependency or addiction has
doubled in four years, Schut said. Those kinds of numbers have raised
questions about a pain-care philosophy that began more than a decade
ago.
Doctors say using opioid-based pills to treat
lingering pain helped millions of people. But they increasingly
acknowledge mounting abuse requires a safety overhaul of their
practices.
State epidemiologists say opioid-related deaths in
Colorado rose from 182 in 2000 to 421 in 2009, before retreating some.
The 2011 count is at least 362 deaths, although the year's review of
death certificates is not yet complete.
Opioids for patients in real need "are far and away the most effective
Kaiser moving aggressively
Kaiser Permanente in Colorado is among those moving aggressively to reform painkiller prescribing and dispensing.
The nonprofit HMO launched a review in January of every painkiller patient in its database. The review spit out lists of patients with complicating risk factors, such as other prescriptions for anxiety drugs or a family history of dependence. The system, covering 535,000 patients and 900 doctors, told each doctor to meet with those on the list within 60 days.
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