Why are doctors writing opioid prescriptions — even after an overdose?

A bunch of researchers at Boston Medical Middle just lately checked out almost 3,000 sufferers who had survived an opioid-related overdose between 2000 and 2012. In response to their just lately printed research, over 90% of those sufferers continued to obtain opioid drugs from docs — even after their overdose. Given the hovering numbers of opioid-related overdose deaths and heightened scrutiny on how these drugs are being over-prescribed, the research findings are alarming and disturbing.

The researchers recognized virtually 3,000 sufferers nationwide who had had a nonfatal overdose whereas being handled with opioid drugs for persistent ache. These sufferers had been adopted for 300 days, on common, after their overdose. Throughout these 300 days, an extra 7% of the sufferers overdosed a second time. Within the majority of instances, the identical physician wrote the opioid prescription earlier than and after the preliminary overdose.

The research did present that as a complete, sufferers acquired smaller doses of opioid drugs after the overdose. However many sufferers had been nonetheless receiving very excessive doses, and people receiving the upper doses had been extra prone to overdose but once more.

The research raises many questions. How may docs proceed to put in writing prescriptions for opioid drugs, even after an overdose? How may docs be so ignorant to the hazards of those drugs?

The issue with gaps in communication — and schooling

The reality is that the docs who wrote the prescriptions most likely didn’t know that the sufferers of their clinic had just lately overdosed. Until the affected person was despatched to an emergency room or hospital affiliated with the prescribing physician, there’s a good probability that the details about the overdose by no means made it again to the physician. Certainly, docs could by no means know until the affected person voluntarily discloses this info.

This communication hole is well-known to these within the well being care system. And this research additional highlights the potential penalties of this poor communication. In any case, details about opioid overdoses have to be communicated again to the prescribing physician in order that she or he can alter ache remedy and supply habit remedy the place indicated.

The research authors give some suggestions for learn how to repair the communication drawback. For instance, the prescription monitoring program — the digital database that docs use to see if sufferers are acquiring a number of prescriptions from completely different docs — may embrace details about overdoses. Or the insurance coverage firms may alert the prescriber a couple of current overdose.

Whereas these measures will surely assist, the truth is that docs have comparatively little coaching in safely managing persistent ache and treating habit. Whether or not in medical faculty or in residency coaching, little or no curricular time is dedicated to serving to docs safely prescribe ache drugs, acknowledge sufferers at excessive threat for overdose, intervene when sufferers must be taken off of opioids, and adequately deal with opioid habit. As such, a important element in lowering the overprescribing of opioid drugs is for medical faculties and residency applications to enhance how docs are educated.

What you are able to do for a liked one who’s had an overdose

Relations and family members of those that just lately survived an overdose can even assist:

  • If somebody you’re keen on has had an overdose, be certain his or her physician is conscious.
  • Contemplate acquiring a naloxone rescue equipment, which can be utilized to deal with an opioid overdose in an emergency state of affairs. These kits at the moment are accessible at drugstores corresponding to Walgreens and CVS.
  • Should you assume your beloved is hooked on opioids, encourage her or him to hunt skilled habit remedy. Medicine-assisted remedy with buprenorphine (Suboxone), for instance, has been proven to avoid wasting lives.

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