Twenty years ago, opioid overdose deaths in the United States were rare. Today, they are the leading cause of accidental death, surpassing motor vehicle crashes. In 2016, more than 64,000 Americans died from a drug overdose, a figure that exceeds in one year the total number of Americans killed during the entire Vietnam war.
The Centers for Disease Control and Prevention has been clear for several years about the cause of our nation’s opioid addiction epidemic. It has shown that a sharp increase in opioid overdose deaths and addiction paralleled an increase in opioid prescribing. In other words, the CDC is saying the opioid crisis was caused by overprescribing of opioids. The medical community did not start prescribing opioids more aggressively out of malicious intent. For most of us, it was a desire to treat pain more compassionately that led to overprescribing. To bring this public health crisis under control, doctors must prescribe more cautiously.
There is legislation that has been adopted in New Jersey and Rhode Island that can help accomplish this. It requires prescribers to inform patients, or parents of minors, about the risk of addiction before an opioid is prescribed and when appropriate, discuss the availability of non-opioid alternative pain relief treatments. This common-sense intervention ensures that patients and parents are better informed about the addiction potential of opioids and it gives them an opportunity to consider alternative methods of pain relief. The National Opioid Commission has made passage of these laws one of it one of its top recommendations and an organization called Prevent Opioid Abuse is working to get every state in the nation to enact it.
If prescribers routinely warned patients about the risk of addiction before prescribing opioids then laws requiring this would be unnecessary. Unfortunately, doctors rarely discuss the addiction potential of opioids before prescribing them. Requiring this conversation will not only result in better informed parents, patients and prescribers; it will save lives and spare many families from the devastating impact of opioid addiction.
All patients and parents in every state have the right to know if the medicines they are prescribed can lead to dependence and addiction and that often safer alternatives are available. Medical professionals must provide this information when opioid prescription is considered. To ensure that this essential conversation between patient and prescriber occurs, all states should follow New Jersey and Rhode Island’s lead and require it.