Opioid Use: A Public Health Crisis

By Sondra Forsyth

In response to concerns about overdose deaths in the U.S. due to prescribed opioid pain killers, the Centers for Disease Control and Prevention (CDC) released new guidelines to help primary care doctors determine when and how best to prescribe them to patients, particularly those with noncancer-related chronic pain. The CDC recommends physicians avoid prescribing opioids such as oxycodone and morphine to most chronic pain patients because the risks of possible overdose or addiction may outweigh the benefits. However, the CDC says the limits on opioid use should not apply to patients with pain due to cancer or end-of-life issues.

Mayo Clinic addiction specialist Dr. Jon Ebbert refers to the opioid situation as a public health crisis. He says, “We must balance the need to develop innovative ways to control this public health crisis with the need to provide patients with chronic pain adequate pain control. Unfortunately, medicine is in desperate want of cost-effective nonopioid pain control modalities.”

Dr. Ebbert believes the new treatment guidelines are necessary, but not sufficient to address a public health crisis of the magnitude seen with prescribed opioids. He adds, “Addressing the epidemic by modifying the behavior of primary care clinicians can only be effective if accompanied by substantial changes in national policy.”

To be successful, Dr. Ebbert recommends these changes:

• Challenge the need for U.S. Food and Drug Administration approval for newer and more powerful opioids
• Increase health insurance coverage of nonopioid modalities for pain control
• Broaden the coverage of addiction treatment and mental health services
• Liberalize the requirements for office-based addiction treatment
• Expand the number of front-line clinicians with training in addiction medicine

This article by Vivien Williams originally appeared on the Mayo Clinic News Network, http://newsnetwork.mayoclinic.org/discussion/opioid-use-a-public-health-crisis/