According to results of the National Survey on Drug Use and Health, in 2015 a staggering 38% of the American population took an opioid (narcotic) for pain. Since 1999, the number of opioid prescriptions has quadrupled, while the incidence of pain has remained stable indicating that they are being prescribed when not needed.  Further, almost 60% of people who took these drugs misused them, that is - took them without a prescription, took larger doses than prescribed, or used the drugs to get high, with 40 % of those getting them as “hand-me-downs” from family or friends who got the drugs from their doctors but had some left over.

Journal article abstract at:  http://annals.org/aim/article/2646632/prescription-opioid-use-misuse-use-disorders-u-s-adults-2015

Summary of article at: https://medlineplus.gov/news/fullstory_167496.html

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Opioids (i.e. .narcotics) are a class of drugs chemically similar to a substance in the sap of the opium poppy seed pod that has been used for pain relief for centuries. According to the National Institute on Drug Abuse, opioids work by attaching to special areas on nerve cells in the brain, spinal cord and other organs, and in turn, block the transmission of pain signals. In addition to their pain relief properties, opioids activate reward regions in the brain that result in euphoria or a high which is what leads to misuse and addiction. Oxycodone (OxyContin®), hydrocodone (Vicodin®), codeine and morphine are commonly prescribed narcotics that are chemically similar to the illegal opioids - heroin and fentanyl. Legal opioids are generally safe when taken as prescribed by a doctor for as limited a period of time as possible to treat acute/short term severe pain. How effective they are in treating long term, chronic pain (pain that lasts more than three months) is unknown.  

According to a 2016 report in the Centers for Disease Control and Prevention’s publication Morbidity and Mortality Weekly Report (MMWR) an estimated 20% of patients at physician offices with acute and chronic pain from health issues other than cancer, receive a prescription for an opioid. In 2012, health care providers wrote 259 million prescriptions for narcotic pain medication, which is enough for every adult in the United States to have a bottle of pills. While prescriptions for these drugs have increased overall, the greatest increase has been in prescriptions from family practice, general practice, and internal medicine physicians when compared with other specialties.

So what can we do about this situation? The Centers for Disease Control and Prevention has developed guidelines to improve the way opioids are prescribed, ensuring that patients with chronic pain have access to safe, effective pain treatment while reducing the number of people who misuse, abuse, or overdose from these drugs. The guidelines are not intended for people in active treatment for cancer, in palliative or end-of-life care.

If you have chronic, long term pain:

  1. Talk with your health care provider about non-opioid pain management first such as:

Acetaminophen (Tylenol®) or ibuprofen (Advil®)

Cognitive behavioral therapy

Physical therapy and exercise

Medications for depression or for seizures

Interventional therapies (injections around the painful area)

(Other possible alternative treatments maybe yoga, acupuncture, TENS unit)

  1. If none of the non-narcotic treatments work and you are prescribed an opioid medication: 

Use it exactly as directed by your health care provider.

Never take more than the amount prescribed, or more often than prescribed.

Avoid taking these other drugs while taking a narcotic pain medication unless specifically advised by your physician:

Alcohol

Benzodiazepines (such as Xanax and Valium)

Muscle relaxants (such as Soma or Flexeril

Hypnotics (such as Ambien or Lunesta)

Any other prescription opioid pain relievers

  1. Work with your doctor to create a pain management plan.
     
  2. Follow up regularly with your doctor about any and all side effects and concerns.
     
  3. Store opioid pain relievers in a safe place and out of reach of others.

Help prevent misuse and abuse by not selling or sharing prescription opioid pain relievers.

Never use another person's prescription opioids.

If you have unused medication, check Dispose My Meds (http://disposemymeds.org/)

to find a pharmacy in your community with a medication disposal program.

 

 For more information:

Which class of prescription drugs are most commonly misused?
https://www.drugabuse.gov/publications/research-reports/misuse-prescription-drugs/which-classes-prescription-drugs-are-commonly-misused

Opioids
https://www.drugabuse.gov/drugs-abuse/opioids

Opium and heroin
https://www.drugs.com/illicit/opium.html

Opioid overdose prescribing data
https://www.cdc.gov/drugoverdose/data/prescribing.html