Every day, over 40 Americans die from a prescription opioid overdose. Since 1999, not only has the amount of prescription opioids sold in the United States almost quadrupled, the deaths from these drugs have also quadrupled in that same time span. With the country in an opioid abuse epidemic, the Center for Disease Control and Prevention (CDC) is doing their part to try and help. In mid-March, the CDC released a report titled “CDC Guideline for Prescribing Opioids for Chronic Pain”, to urge primary physicians not to prescribe opioids for chronic pain in most situations.
The Opioid Numbers
Approximately 11.2 percent of the US adult population is suffering from chronic pain, and about 3 to 4 percent of adults are prescribed long-term opioid therapy. While there is evidence that supports the short-term use of opioids (pain lasting 12 weeks or less), most studies have only lasted 6 weeks or less. Do the uncertain benefits of opioids outweigh the very clear risks of addiction or overdose? After all, nearly all the opioids on the market are just as addictive as heroin.
The CDC reports that from 1999-2014, more than 165,000 people died as a result of overdoses related to opioid pain medications in the US. An estimated 1.9 million people abused or were dependent on prescription opioids in 2013 alone. In an article in The New England Journal of Medicine, Dr. Thomas Frieden and Dr. Debra Houry of the CDC stated, “We know of no other medication routinely used for a nonfatal condition that kills patients so frequently”.
CDC Recommendations for Opioid Use
The CDC made many recommendations in their report, and emphasized three core principles:
- Nonopioid therapy is preferred for chronic pain outside the context of active cancer, palliative, or end-of-life care.
- When opioids are used, the lowest effective dose should be prescribed to reduce the risks of opioid abuse or overdose.
- Clinicians should exercise caution when prescribing opioids and should monitor all patients closely.
Studies have demonstrated that movement, exercise and individualized physical therapy are effective, and possibly even better options for treating chronic non-cancer pain. Physical therapists are highly trained to create focused workouts to target the muscles where you feel pain and build strength and flexibility. This will help the joints work better and have more support.
With the release of the CDC report, primary clinicians should be working closely with physical therapists to create individualized treatment plans for their patients suffering from chronic pain. Through concerted efforts between doctors and physical therapists, it is the hope that by the time the CDC revisits the guidelines in the future, we will have fewer people dying from opioid abuse or overdose.