Prescription Opioid Misuse : A Significant Public Health Issue

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Prescription opioid misuse has emerged as a significant public health issue in the United States. Since the late 1990s, nationwide sales of prescription opioids have risen 4-fold, and with this, the rate of admissions for substance use treatment and the rate of death from opioid overdose have grown proportionately.1 A number of policy approaches and initiatives have been developed in an attempt to stem the tide of this epidemic. These include implementing physician training programs about the appropriate prescribing of opioid therapy, developing prescription monitoring programs, and facilitating access to naloxone to reduce death rates among those who overdose. In general, these strategies have focused on detecting and preventing…show more content…
In New York City, voluntary guidelines that call for practitioners to prescribe no more than 3 days’ supply of short-acting opioids have been adopted by many hospital emergency departments. Other states have also imposed limits on the days’ supply and dose of prescribed opioids, although these are not nearly as restrictive as what is being considered in Massachusetts.3 Mandated limits on opioid prescriptions for acute pain offers the promise of advancing the safe use of these medications in two ways. First, it will reduce the exposure of first time users to these addictive substances following episodes of acute pain. For some patients who come to misuse opioids, the euphoria or sedating effects of these medications are initially experienced in the context of routine medical care. There are countless anecdotes of patients who take opioids for a minor orthopedic injury or some other acute pain condition and then go on to use prescription opioids non-medically. A recent population-based study suggested that 6% of incident opioid users progress to long-term use.4 Another study found that patients who received opioids following minor surgery were 44% more likely to become long-term opioid users compared to those who did not.5 Decreasing the initial amount dispensed may potentially lessen the risk that patients develop an affinity for these drugs and transition to chronic use or misuse. Second, limiting the dispensed supply
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