JustCare

Tag: Opioids

  • Pharma’s role in our opioid crisis

    Pharma’s role in our opioid crisis

    By some accounts, 2.6 millions Americans are addicted to painkiller medications–opioids–and nearly 30,000 people have died from them as we have written about on Just Care. Last Week Tonight’s John Oliver calls out Pharma for its role in our opioid crisis.

    Oliver explains that most people start with OxyContin or another prescription medication and then, over time, move to heroin if they cannot get a prescription. People become so addicted that they hurt themselves so that their doctors will prescribe them an opioid. (Note: Mixing opioids with tranquilizers, alcohol and other drugs can cause serious health risks. Mixing opioids with benzodiazepines is the most frequent cause of accidental death from drug overdoses.)

    Now doctors in the U.S. write nearly 250 million prescriptions for opioids every year. Back, in the early 90’s, doctors were afraid to prescribe opioids very often for fear they were addictive. But, the head of the department of Health and Human Services at the time, Louis Sullivan, claimed that opioid addiction was a myth. And, soon after, pharmaceutical companies began marketing opioids with a vengeance.

    To expand their market share, pharmaceutical companies argued that opioids were not simply for acute pain, such as arthritis or back pain. Purdue marketed OxyContin heavily beginning in 1996. By 2000, doctors wrote 6 million prescriptions for OxyContin while evidence grew that opioids were riskier than authorities had claimed.

    The government fined Purdue $639 million in 2009 for misleading marketing. But, the fine seems to have been marginal relative to the profits, and sales are bigger than ever. The CDC now recommends use of nonopioid therapies such as physical therapy and meditation, when possible.  Other drugs such as acetaminophen, ibuprofen or naproxen to treat pain have substantially fewer risks.

    If doctors feel the need to prescribe opioids, CDC recommends they do so in low doses and small quantities. The CDC found a 14 percent increase in deaths from opioids between 2013 and 2014. Overdose deaths from opioids have tripled in the past 20 years.

    While the CDC and others work to drive down opioid prescriptions, Oliver lets us know that pharmaceutical companies have found a new market related to opioids. They are promoting a prescription drug to fight a side effect of opioids–constipation.

     

    Here’s more from Just Care:

  • Opioid deaths on the rise

    Opioid deaths on the rise

    A new report from the Centers for Disease Control (CDC) warns of the dangers of opioids.  Last year opioid pain relievers and heroin alone were responsible for some 47,000 deaths in the United States in 2014.  All told, between 2000 and 2014, almost 500,000 people died from drug overdoses. In 2014, 60 percent of these overdoses involved opioids. (Click here for Dr. Salomeh Keyhani’s post on how opioids can kill you.)

    The opioid problem appears to be growing. The CDC found a 14 percent increase in deaths from opioids between 2013 and 2014. Overdose deaths from opioids have tripled in the past 20 years. The number of deaths from opioids now compare with deaths from auto accidents and guns.

    There was a 9 percent increase in deaths from oxycodone and hydrocodone, the two opioids most involved in overdose deaths, between 2013 and 2014.  And, there was a 26 percent increase in deaths from heroin in that same period, totaling 10,574.

    A new Medscape survey shows that the majority of doctors (74 percent) are very concerned. The vast majority of doctors spend time with patients explaining proper use of opioids, but far fewer spend time on how to store and dispose of them safely.

    WebMD reported a major rise in opioid prescriptions between 1991 and 2011, from 76 million to over 219 million a year.

    Overdose deaths are up for both men and women of all ages, including blacks and whites. Five states with the highest drug overdose rates were New Mexico, New Hampshire, West Virginia, Kentucky and Ohio.

    The CDC recommends doctors prescribe smaller quantities of opioids for a short term to treat acute short-lived pain. For long-term pain, it recommends that doctors first prescribe other less addictive drugs than opioids and, only if these drugs don’t work to relieve pain, begin prescribing the lowest dose of opioids so long as risks do not outweigh benefits.

  • Health caring for mom: Three ways to let your mom know you love her on Mother’s Day

    Health caring for mom: Three ways to let your mom know you love her on Mother’s Day

    Mother’s Day is the time to show your mom some serious love. But how? Most of us love flowers and chocolate. So, consider getting mom a little of both. What we really treasure, though, is the priceless gift of time together and conversation. And there are few things more important to talk about than your mom’s health.  So here are a few priceless gifts for mom on her special day:

    1. Make sure your mom is safe and healthy.  Talk to her about all of the drugs she’s taking, both over the counter drugs and painkiller prescriptions. If your mom has a chronic condition like asthma or diabetes, find out whether her primary care doctor is doing a good job of coordinating her care. Click here to learn how your mom’s primary care doctor can help her. And, if your mom wants to stop smoking, lose weight or change another unhealthy behavior, here are some tips for motivating her to do so.
    2. Talk to your mom about planning for her future health care needs. Who would she want to take care of her when she cannot take care of herself?  Would she like to remain at home as long as possible? What are the tradeoffs she would like to make? And, make sure your mother has a reliable health care proxy and a living will. (You should have those too!)  Click here for free help with these advance directives.
    3. Double check that your mom is getting the preventive care services she needs.  She should get regular pap tests, pelvic exams and breast exams. If she’s over 60, she should get a shingles vaccine.  Medicare and most insurance cover all these tests in full. Next time she’s headed to the doctor, consider tagging along. Mom, like all of us, could use a health care buddy to ask the questions she might not ask.

    These are important conversations. Most of us know we should talk to our mothers about their health, but we never quite get around to having the actual conversation. Why not use Mother’s Day as a reason to get serious about your mom’s health? Just talking to your mom about these issues can be healthy for her.