Rising overdose risks from increased painkiller prescribing

An article in MedPage Today considers the fact that over the past few decades, opioid prescriptions have multiplied dramatically, but opioid abuse has also increased in parallel among chronic pain patients. It might be a surprising fact that opioid analgesics cause more deaths from overdose than either cocaine or heroin, in the United States.

Short-acting opioids like Dilaudid and Vicodin can be used safety for short-term pain relief, but if used more chronically have high abuse potential. Longer-acting opioids like methadone, Suboxone and fentanyl have less likelihood of abuse, but even so, methadone is the most frequent cause of overdose deaths among all narcotic painkillers.

One of the key challenges today for physicians who prescribe opioids as pain killers is to judge which patients present high risk for abusive and addictive behavior. There is a survey tool called SOAPP (Screening and Opioid Assessment for Patients with Pain) which helps physicians identify persons who might be likely to abuse pain killers. However, pain patients have been known to engage in deceipt when answering questions from this survey, thus reducing its value. Ultimately, the authors conclude, better methods – both of interviewing patients when treatment begins and monitoring narcotic use subsequently – must be employed by healthcare professionals, to reduce opioid overdose and untimely death.

Sources: MedPage Today; Butler, et al, Journal of Pain, 2008.