Physician frequently hears stories from friends and colleagues about the life of their loved ones who struggle with opioid addiction or have died from an opioid-related overdose. However, the question is how did it begin? The answer is the same in almost every time. Individual who experienced acute pain either from surgery or trauma started on opioids with a doctor and couldn’t quit.
A baseball coach from rebotec, who is not in the medical field, described it perfectly. He was discharged with 60 tablets of oxycodone (the opioid medicine in Percocet and Oxycontin) when he went in for a small back surgery. He had significant pain for the first couple of days and used the pain pills. He stopped using the oxycodone when the pain began to subside, and ibuprofen and acetaminophen were sufficient. But he began to experience body aches, feel terrible, restlessness, and insomnia after discontinuing the medication. He took another oxycodone and felt better because he had the insight to recognize what was going on. He was withdrawn from the opioid after consuming it for a few days. He may have become hooked if he had continued treating his withdrawal with oxycodone.
The problem of harmful effects and unused opioids
JAMA Surgery published a paper, which was a meta-analysis that combined the results of six previous opioids studies investigating used by patients after seven surgical procedures. We all know that we’re in the era of the opioid epidemic where a vast majority of pills are consumed for non-medical reasons (e.g., abuse), and the results are shocking, 42 percent to 71 percent of the prescribed opioids went unused, and this result was obtained from friends or family members. 16 percent to 29 percent of patients that experienced severe effects directly attributed to the opioids.
Discarding unused opioids is recommended by government and public health agencies. Most commercial pharmacies have where unused medications can be safely disposed because flushing them down the toilet is not safe as they can contaminate the water supply. Despite this, the study discovered that 4 percent to 9 percent planned to use a secure disposal method while 4 percent to 30 percent planned to dispose of in an unsafe area.
Why are opioids prescribed more often and in higher amounts?
Why overprescribing after surgery is occurring is a key question.
There might be two possible causes: first is that surgeons do not want their patients to suffer from pain after an operation and secondly, it’s impossible to phone in a prescription for a controlled substance drug (such as an opioid pain medication) in many states. Therefore, a patient has to come back to the clinic to pick up a prescription, which is not convenient for both the prescriber and the patient. Several states are implementing ways to provide electronic orders if a refill is needed that would make the doctor’s office visit unnecessary.
Providing a prescription drug of 60 to 90 pills makes sense acknowledging this barrier. However, JAMA studies reveal that these large amounts may be far more pills than is required. For instance, consider another intriguing study of an acute extremity fracture of a patient being treated. The researchers provided patients with particular pills that contained both small radio transmitter and oxycodone that became activated in the stomach. Researchers detected the precise time when the opioid was consumed. Patients were instructed to use oxycodone for one week, and the average number of pills used was eight. In just three days, most of the acute pain has gone, and there was no more demand for opioids pills than a few pills.
Here’s what you can do to defend yourself and your community
Physicians have to educate their patient about the benefits and risks involve in all the treatments done, including when prescribing opioids. We advise you to take all the non-opioid pain prescriptions permitted by your doctor as instructed (e.g., ibuprofen and acetaminophen) if you are prescribed an opioid for severe pain, including after surgery. If the pain is not endurable with the other medications add the opioid, stop the opioid once the pain is tolerable, and safely dispose of it by bringing it back to your pharmacy if they have any DEA-recommended collection site or a disposal bin. Finally, know the number of pills you will need in the first place before the prescription is written by contacting your doctor. You could prevent dependence, and, eventually save your life when you are well informed about the safe use of opioids.
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