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Opioids, including heroin, but also prescription opioids like oxycodone, hydrocodone and the synthetic painkiller fentanyl, killed more than 42,0000 people in 2016 – and according to the CDC, 40% of those overdose deaths involved a prescription opioid.
Opioids do not discriminate; anyone who takes them can become addicted, regardless of their background or income level. Once hooked on opioid painkillers, addicts often turn to heroin, which is both cheaper and easier to get. In fact, 4 out of 5 new heroin users started with prescription opioid painkillers.
Widely criticized for its marketing practices, Purdue Pharma LP, maker of the opioid painkiller OxyContin, announced Saturday that it will stop promoting opioids to doctors and has cut its sales department by half. This comes as the state of Alabama announced last week that it was suing Purdue Pharma, joining a number of states, counties, and cities accusing the company of using misleading marketing that downplayed the dangers of addiction, and overstated the benefits of using opioids to treat long-term, chronic pain, rather than short-term pain.
The result has been rampant overprescribing of addictive painkillers – in 2013 alone, doctors wrote nearly a quarter of a billion prescriptions for opioids, enough for every adult in America to have their own bottle of pills. The most common drugs involved in opioid deaths include prescription oxycodone (like OxyContin), hydrocodone (including Vicodin), and methadone, an opioid commonly used to treat opioid withdrawal symptoms.
Purdue is no stranger to the legal system; in 2007, the pharmaceutical company and three of its executives pleaded guilty to federal charges related to misbranding OxyContin and agreed to pay $634.5 million to resolve a Justice Department Probe. Purdue also reached a nearly $20 million settlement with 26 states and Washington D.C. that same year, and in 2015, agreed to pay $24 million in to resolve a lawsuit by the state of Kentucky.
“We now know that overdoses from prescription opioids are a driving factor in the 16-year increase in opioid overdose deaths,” states the CDC website on the opioid epidemic. Citing DEA data and a CDC report, the website goes on to state that the amount of opioids sold to doctor’s offices, hospitals, and pharmacies “nearly quadrupled between 1999 and 2010,” though pain levels in America had not increased, and that deaths from prescription opioids have more than quadrupled since 1999.
In a recent Reuters article, Purdue said it would inform doctors on Monday, February 12, 2018 that it was stopping the practice of sending sales reps direct to physician offices to discuss its opioid products, and will direct doctors with opioid-related questions to its medical affairs department.
The restructuring announced Saturday is another step toward mitigating the catastrophic levels of opioid abuse and overdose deaths in this country that many argue was fueled by pharmaceutical companies like Purdue Pharma.
When used for pain management in longstanding cases, the development of drug tolerance with opioid use is fairly common. How can you work with your workers comp insurance consultant to protect workers against tolerance dangers?
Know the Signs
Tolerance is a normal physiological response: The body becoming accustomed to a drug dose over time. If opioids are increased and symptoms stabilize – that's a prime indicator of drug tolerance.
Dangers of Tolerance
Dependence occurs when the body gets sick without opioids for 12 hours or more. Symptoms of withdrawal include nausea, diarrhea, anxiety, insomnia, sweating, irritability, and runny nose.
Once opiate tolerance develops, the likelihood of physical dependence (addiction) rises. The increased perception of pain often leads to abuse, as sufferers seek to use the drug on their own terms: (1) higher than prescribed doses, (2) dependence on its mood-altering effects, and (3) doctor shopping or gaining scripts from multiple prescribers.
The second leading cause of death in the U.S., opiate overdose is increasingly common with those who’ve developed a tolerance, particularly following periods of abstinence (such as incarceration), after which they return to their previous (but now overly high) dose. This often leads to a fatal overdose, particularly alongside alcohol, benzodiazepines, sleeping pills, antihistamines, and antidepressants. Signs include an inebriated look, mood swings, excessive sleepiness, slow breathing, and confusion.
Tolerance is NOT a Permanent Condition
Physical tolerance only remains with continued intake of opiates. Psychological tolerance, however, is another matter, lasting many years post-addiction.
Prevent addiction and protect injured workers with the help of a workers comp insurance consultant who’s on your side. Join the team at Minnesota Comp Advisor today.
In today’s addiction-riddled, drug obsessed world, employee health management regimes continue to place opioid use for chronic, non-cancer pain (CNCP) under the microscope for efficacy. Does it really work? And if so, do benefits outweigh risks? Or are the use of these drugs merely a shot in the dark, prescribed by physicians with a lack of evidence-based alternatives?
Opioid misuse on the one hand, undertreated pain on the other
CNCP is common, affecting 10-20% of adults, particularly the elderly. There exists to-date no singly effective drug or drug group that works well for its alleviation. NSAIDs are viewed as dangerous and often avoided, other licensed medicines are prohibitively expensive, and non-drug protocols are few, with scant evidence of efficacy, leaving opioid use to soar.
Does that mean they work?
While there will be some who get demonstrable pain relief with opioids without experiencing long-term harm or side effects, evidence is weak - opioids should not be the drug of choice for chronic pain. Consideration must be given to treating pain while avoiding risks - without taking sides in the national debate. A decision to exclude them a priori would appear based on ignorance/fear - not science.
A sensible approach
The situation here is no different than in others where a small number of individuals benefit immensely but most do not – a chance for pain relief should be given - albeit at sensible dosages, and alongside non-drug options, until efficacy is verified. High-doses and long-term use must be avoided to circumvent adverse risks, allowing those who can benefit to do so.
Current employee health management tactics seem risky? Minnesota Comp Advisor can help. Contact us today.