Opioid Override

Until recently, there was a dramatic disconnect between this research and drug court operations. The consequences of this disconnect included relapse, overdose, and death. While drug courts were designed to accommodate those in need of medical care, most operated under the misguided and dangerous practice of requiring defendants, as part of their successful program completion, to stop taking life-saving addiction medication prescribed by their physicians. This practice, which is at odds with decades of scientific and medical research, put individuals with opioid addictions in the precarious position of either having to stop taking their effective medication and risk relapse or use their medication and face incarceration. To compound matters

Opioid abuse, misuse and overdose is a problem in The United States. You can’t turn on the TV or read a newspaper without some mention of the epidemic. This issue has caused the practice of prescribing or taking narcotic pain medication to be looked at under a microscope. Patients are fearful to use some necessary pain medication, because they may become addicted. Other patients who genuinely do have pain and need medication are having a tougher time obtaining the help they need. The problem of abuse and addiction is tough to solve since for some people the medications are the only way they can function and live a semi-normal life. A patient with pain may be hesitant to visit the doctor and

As better and more comprehensive education is provided both to the general public and practicing clinicians the hope is to reduce the negativity surrounding the users of opioids, and to eliminate demeaning language coupled to them as well. This could improve patient morale and help the needless continuation of physical suffering within patients, as they would be more comfortable approaching and using opioids for therapeutic purposes1. That being said there are those within our communities who do abuse these substances and pharmacists must recognize the signs of abusers, it is important for them to reach out, without comment, to help those suffering from opioid abuse once they have been

Individuals who use Opioids are Addicts. The history of this very debatable topic is very educational and interesting. Opioids are drugs that are prescribed for severe to chronic pain, some examples of opioids are: morphine,?methadone, Buprenorphine,?hydrocodone, and?oxycodone.?Heroin?is also an opioid and is illegal. Opioid drugs sold under brand names include: OxyContin?,?Percocet?, Palladone?(taken off the market 7/2005),Vicodin?, Percodan?, Tylox? and?Demerol? among others. These drugs are also classified as a schedule II drug. Substances in this schedule have a high potential for abuse which may lead to severe psychological or physical dependence. Substances are placed in their respective schedules based on whether they have a currently accepted medical use in treatment in the United States, their relative abuse potential, and likelihood

It is important for our culture in western society to educate doctors on how to modify and limit their prescribing behavior so that less people become dependent on opioid medication. Doctors must start limiting and monitoring the number of opioid prescriptions they administer to patients. Limiting the number of prescriptions will lower the chances for potential abuse within patients, as well as lower the ease of access and circulation of opioid medication on the streets.

While, CURES helps to identify red flags, there are no guidelines for pharmacists to ultimately make the final decision to fill an opioid prescription or not. CVS though, is making substantial changes to its pharmacy program. If a patient has a prescription for several weeks’ worth of an opioid and wants to fill that prescription for more than seven days, pre-authorization will be required and the drugs will have to be paid for out of pocket. CVS pharmacists will begin providing patients with thorough explanations as to why some of their opioid prescriptions won’t be filled. They will also be sure to counsel patients on the dangers of opioid dependence and addiction. As mentioned in Time, Dr. Steve Stanos, president of The American Academy

Vivek Murthy, a U.S. Surgeon General, said he wanted to change the way Doctors have been taught to handle pain management for the last twenty to thirty years (824). The reason Murthy wants to do this is because while he was reading a training document for nurses and doctors it claimed , "If your patient is concerned that they may develop dependence on opioids, you can safely reassure them that addiction to opioids is very rare in patients who have pain" (823). This document also reassured doctors they could prescribe opioids as a long-term treatment. The Center for Disease Control and Prevention advises doctors that pain-relieving effects may wear off for long-term users(824). This explains how opioids can be used to deal with pain management, but if used as a long-term treatment it can create an

This lack of independence could further cause the patient to feel hopeless in their own recovery, which would lead to a lack of effort in getting better, causing a strain on the family members who are doing everything they can to improve the patient’s condition. Secondly, in spite of the short term effects, doctors do not practice appropriate care when prescribing opioid-based medications. According to Anna Lembke, in recent years American doctors have been “prescribing opioids with abandon for chronic, non-terminal pain” (“problem”), leading to an “epidemic of opioid painkiller overprescribing” (“Drug”, 57). If the patient feels like the doctor is giving him an opioid medication because it is the easiest course of action to deal with the pain, the patient may not fully trust his or her doctor to have the patient’s best interests at heart. The family of the patient may have the same mistrust for the doctor. Further than mistrust, it is possible that the patient and those caring for him or her may question the doctor’s knowledge and credentials. This mistrust could lead to the patient and the family (specifically the caregiver) neglecting to follow the doctor’s specific instructions as to usage of the medication, which could cause the pain relief to be less effective than is necessary, or could cause the patient to be in

According to the Department of Health and Human services, over 650,000 opioid prescriptions are dispensed in one day. This translates to around 230 million prescriptions each year. This amount just barely falls short of being high enough to give every adult in the United States their own bottle of opioid pills. The loose prescribing habits of medical professionals are to blame for these absurdly high numbers. Current doctors will prescribe an opiate-based painkiller for anything from a backache, toothache, to even headaches. To give patients “highly addictive” drugs for low scale chronic pain over the three-days recommended max incurs high risk for tolerance, dependence, and potential addiction to opioids. Some would argue that doctors are simply doing their job by solving their patient’s pain problem and that people should not intrude upon a medical professional’s expertise. However, while doctors should be unbiased pillars of medical advice and treatment, they should also take into account the risks involved with their treatment for their patient’s sake. Particularly for opioid prescriptions, doctors should have to abide by dosing criteria, receive guidance on when to seek consultation, and know how to use their state’s prescription drug monitoring program (Alexander et al., 2015). According to Alexander et al., (2015) Prescription Drug Monitoring Programs (PDMPs) are underutilized by 81% of all prescribers.

Doctors and clinical prescribers have discovered their role in curtailing the increased opioid prescriptions in America. It is without a doubt that they play a role in facilitating the opioid misuse endemic in the past by being enablers of the situations. When patients ask for pain medications, they do not take time to analyze the pain complaints or suggest alternative medications other than opioids. Even in instances when one doctor declines to offer a patient an opioid prescription for their pain needs, the patient is likely to find another who will give the prescription. However, there has been wide recognition of the opioid misuse endemic such that clinical prescribers are practicing more vigilant prescribing and are advocating opioid-free

Opioid overuse, is one of the major overuse of analgesic problem that is addressed by the CMS in the part D drug benefit program. This is an example of unnecessary drug use and its financial impact on health economy. Opioids are considered the top most highly used therapeutic class of drug among part D beneficiaries that accounts for 5 percent of total spending and quantity covered under Medicare part D program (Medicare Payment Advisory Commission). It is estimated that in 2012, nearly 12.3 million or 36 percent of part D enrollees were asked to prescribe opioid in at least one prescription. Therefore spending on abused opioids rise from $1.5 billion to $3.9 billion from 2006 to 2014, showing 156 percent of increase in the spending (HHS Office

In 2012, enough opioid prescriptions were written to cover every adult in America at least once , but that trend has already begun to be reversed. Last year, 17 million fewer opioid pain relievers were prescribed than in the year before. The concern is that the new guidelines and policies are blunt instruments that are denying patients who appropriately use their prescription opioids access to medications, rather then blocking access for the recreational, illicit user of opioids. There are reports of physicians who are wary about writing prescriptions for opioid pain relievers, those who blindly follow guidelines without considering the nuances of an individuals’ needs, and those who have

Opioid analgesics are the widely prescribed medications for both non-cancer and cancer-related pain. Opioid dugs provide significant benefit for patients, when they used for their approved indications. However, opioids are also carries the risk of abuse, misuse and death. In 2009, more than 15,500 people died in the United States due to overdose of narcotic pain relievers. In order to combat the opioid misuse, abuse, and addiction, FDA has taken many steps to address this problem over the last few decades. The task force’s multi- pronged approach targets, drug development, opioid labeling, prescriber education, patient education, exploring innovative packaging and storage to prevent abuse, encouraging the development of products that treat abuse and overdose and role of other agencies.

Opiates, otherwise known as prescription painkillers, have become an enormous problem in the United States. Addiction, overdoses, and death are only a few of the problems caused by opiates. Painkillers can be prescribed to help lessen chronic pain, pain from surgery, pain from serious accidents, or pain from terminal diseases. Opiates are highly addicting and have become highly abused in the United States in the past few years. Prescription painkillers need to be banned in the United States because of the dangers they bring to the patients to whom they are being prescribed. The FDA needs to become more involved in the awareness of how dangerous these drugs are and place a ban on them.

While our major access to these drugs is doctors, we cannot simply lay blame on them, as there is not enough knowledge about these treatments to correctly appropriate drugs, and therefore extra is given (Hemphill 373). Alexander of the Department of Epidemiology of the Journal of the American Medical Association, states that “There are serious gaps in the knowledge base regarding opioid use for other chronic nonmalignant pain” (Alexander 1865-1866), which leads to the unfortunately large number of leftover drugs. In fact, the main place that people get their drugs are from leftover prescriptions (Hemphill 373).