In reply to the op-ed in the Press of Atlantic City March 31 on varying opioid prescription practices, I make the following observations.
The USA consumes 80-90 percent of the world's opioids, and it is a leading killer of young adults.
U.S. physicians prescribe 82.5 opioid prescriptions per 100 patients getting pain medications.
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Much of the opioids get diverted from legitimate medical purpose and are used for non-medical purposes. Sixty-four percent of abusers get opioids from a family member or friend. 4.3 percent get them from drug dealers.
In 1997, 670,000 prescriptions were written for OxyContin, and in 2006 it increased to 6.2 million, and more today.
The Joint Commission on the Accreditation of Healthcare Organizations, which accredits hospitals nationally, stated that hospitals must implement “pain as a fifth vital sign” and narcotics prescribed until patients are satisfied. Pain relief is a measure of patient satisfaction, and this resulted in a tenfold increase in the late '90s and early 2000s. Physicians have been successfully sued for prescribing too little and too many pain medications.
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In the Netherlands, surgery for a fractured ankle is treated with Tylenol, and patients there are more satisfied than U.S. patients treated with oxycodone for the same surgery.
The dependency on opioids must change, and patient demands and physician acquiescence must stop.
There are now CDC guidelines published in 2016 for prescribing opioids that need to be followed.
Bottom line, I believe, is that prior to getting their first opioid prescription, patients must sign an informed consent, just like they do for an operation, clearly stating the risks and benefits as well as the limits of use.
John C. Baker, M.D.