The Centers for Disease Control and Prevention (CDC) reports Americans age 45 to 64 accounted for about 44% of deaths from overdoses in 2013 and 2014. The proportion of adults 50 and older seeking treatment for opioid addiction has increased dramatically in recent decades.
In 2016, the CDC issued new guidelines for primary care providers who write 50% of the prescriptions for opioids. The new regimen discourages the use of opioids for chronic pain other than for cancer patients and those at the end of life.
If an opioid is prescribed, CDC recommends faster-acting medication with a short duration of pain relief, rather than slower-acting, extended-release drugs with a longer duration. The CDC released data last month showing that those who started out on long-acting drugs had the highest probabilities of long-term use.
An unexpected finding was that the short-acting drug tramadol, considered less of a risk for abuse than other opioids, had the next-highest probability of long-term use. And 1 in 7 people who received a refill or second opioid prescription authorized were on the drugs a year later.
Michael Barnett, MD, assistant professor of health policy and management at the Harvard T.H. Chan School of Public Health, says older patients “have the most to lose from getting the wrong opioid prescription or dose.” They are especially vulnerable to falls, fractures and respiratory arrest when using prescription narcotics—and often they are taking other medications that magnify the risks.
“Even one prescription can be a trigger for long-term use,” says Dr. Barnett. “We have to figure out how to encourage safe prescribing without undertreating pain.”
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The Great Plains QIN is partnering with providers, pharmacists and to reduce and monitor taking several high-risk medications which includes opioids. Click here to learn how you can partner with us to reduce opioid use in our region and to access pertinent tools and resources.