New CDC Guidelines Underscore Need for Change in Painkiller Prescribing Practices

Below is an editorial by Steve and Elaine Pozycki. They are board members of the Partnership for a Drug-Free New Jersey with Elaine serving as Co-Chair.

Guidelines recently issued by the Centers for Disease Control and Prevention take direct aim at the over-prescribing of opiate-based painkillers, urging primary care doctors to try alternatives such as physical therapy, exercise and over-the-counter pain medications first. Underlying these strong recommendations to prescribe opiate-based painkillers, such as Oxycodone and Vicodin, sparingly is that the over-prescribing of these highly addictive drugs is the primary cause of our epidemic of addiction, both to these pills and to heroin, their illegal street cousin—an epidemic that has become the leading cause of accidental death in the United States and in New Jersey, taking nearly 30,000 lives in 2014. 

A recently released John Hopkins University School of Public Health Report on the Opiate Epidemic, which strongly recommends tightening up prescribing practices, notes, “Doctors often prescribe pain medications in quantities and for conditions that are excessive, and in many cases, beyond the evidence base.” And 85% of doctors themselves say that opiate based pain medications are over-prescribed. 

Recognizing this fact, CDC guidelines recommend that doctors adopt “best practices for clinicians to follow when prescribing necessary opioid therapy, including open communication with the patient about the known risks and benefits, setting realistic goals for pain and function, and prescribing the lowest effective dose.” We are pleased that these guidelines, a product of top doctors and addiction experts, are now in place. 

Simply issuing voluntary guidelines, however does not go far enough given the scale, mounting human costs and expense of this epidemic. That is why, we are continuing to push hard for legislation that reflects this CDC recommendation and requires doctors to discuss the risks of addiction with patients. 

We are beginning by urging the state legislature to adopt legislation (A 3424), sponsored by Assemblymen Lagana (D-38) and Diegnan (D-18), that provides parents with the critical information needed to make an informed decision about whether their teenager should be prescribed an opiate-based painkiller by requiring that physicians and other prescribers discuss the potential risks of dependency before writing a prescription as well as, where appropriate, discuss potential alternative treatments. Research shows that the still developing adolescent brain is at particular risk from opiates and that prescribed opioid use as a teenager increases the risk of future addiction by 33%. When parents make a decision to go forward with an opiate prescription, this essential parent education provides the added benefit of alerting them to be on the lookout for any signs of dependence developing. 

A more expansive version of this legislation, put forward by Senator Loretta Weinberg (D-37) and Senator Joe Vitale (D-19), which requires a conversation with adult patients as well, passed the state senate overwhelmingly at the end of 2014. Yet it failed to receive even a hearing in the state assembly before the end of the legislative session in 2015. 

As the epidemic proceeds apace, we urge the NJ Legislature to act on this and other prevention initiatives. Delay, unfortunately, means more ruined lives and avoidable deaths (the mounting impacts of this epidemic will be discussed at the Partnership for a Drug-Free NJ's RxForum on April 15 at Monmouth University).

Elaine and Steve Pozycki are board members of the Partnership for a Drug-Free New Jersey with Elaine serving as Co-Chair.  Steve is the Founder and CEO of SJP Properties

Comments

Ruthann Gaspari-Blanchard
Posted 4/14/2016 9:53 AM

i agree that the amounts of pain killers given by doctors are absolutely KILLERS as the name of them state. I believe that more people (young and old) are addicted and overdosing .i lost my son, robert, to accidental overdose in April 2013. It is heartbreaking to say the least. Congressman, legislators ,doctors and parents need to be educated on the disease to avoid further excess deaths. There are pain pills and medical shots that can be giving that are not a narcotic . Why would any doctor prescribe excess amount of narcotic to anyone knowing it can be addictive? Something must be done and needs to be done now!! ASAP !!

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