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With clear evidence that limiting the number of prescriptions was increasing the death rate by pushing non-medical users towards heroin and fentanyl, the last thing we want to hear about, is to A politician who plans to double this deadly policy by asking for new limits of prescriptions for sufferers.
3-day limit on opioids
Yet Senator Robert Portman (R-OH) is proposing legislation that would impose a three-day national limit for opioid prescriptions as a result of surgeries. He will be kind enough to allow exceptions for people with cancer, chronic pain and "other serious problems" no matter what it means.
Government data show that there is no correlation between the number of opioids prescribed and their non-medical use or the occurrence of a disorder of opioid use. Overdose rates have exploded over the past 10 years, while high-dose opioid prescriptions have dropped by more than 58% and the total volume of opioids delivered has decreased by more than 29% . To impose a national limit of three days would be an unfounded and cruel intrusion of the government into the practice of medicine.Seventy-five percent of opioid-related deaths in 2017 involved fentanyl and heroin, and less than 10% of prescription pain medications, without also involving heroin, fentanyl, cocaine, tranquilizers or alcohol.
The senator determined that "after the second or the third [postoperative] other pain medications are just as effective (sic). During my 35 years as a general surgeon, I found that my patients who were recovering from major surgery needed prescription opioids to control their pain for more than 2 years or more. 3 days. . It is bad enough that many states have opioid prescriptions with a 5 or 7 day limit, forcing many patients with severe pain to go to the doctor several times for treatment renewals. The imposition of a national limit of three days does not allow for understanding science. It would be an unfounded and hard intrusion of the government into the practice of medicine.
Senator Portman, like so many other politicians with no training in medicine or pharmacology, is guilty of misinterpreting and misapplying the opioid prescription guidelines published in 2016 by the Centers for Disease Control and Prevention. He still has to believe that today's non-medical users are yesterday's pain patients, although, as mentioned above, there is no evidence of correlation between the two.
The rate of overdose increases regularly
It also seems to think that there is a high risk of addiction in opioid patients who have been prescribed acute post-surgical pain. Yet a well-published study in the medical journal BMJ Harvard and Johns Hopkins researchers examined 568,000 "naive" opioid patients from the Aetna Medicare Database, who had received opioids prescribed for acute postoperative pain over the 2008-2016 period. The researchers found that the "total misuse rate", that is, the rate of all opioid misuse diagnoses among the 568,000 patients who had been prescribed opioids, was 0.6%.
Senator Portman told reporters in Ohio, "After four, five, or six days, the chances of becoming addicts are higher." Maybe he reacts to the researchers' statement of BMJ report that each refill and each additional week of opioid use was "badociated with an adjusted increase in the rate of abuse of 44%". But a closer look at their data shows that the incidence of opioid abuse has risen from 145 cases per 100,000 person-years, or 0.15% per year in patients who do not have a history of opioid abuse. did not renew, at 293 cases per 100,000 person-years, or 0.29% per year, among those who did a renewal. Indeed, it is almost double. But if you double a very small number, you still get a low number.
If Senator Portman wants to develop legislation that can truly save lives, he should propose the repeal of the federal government's "Crack House" status.
The fact is that the rate of overdose attributable to the use of licit and illicit drugs for non-medical purposes has been increasing exponentially since the 1970s and shows no sign of slowing down. The only thing that has changed over the years is the drug in popular use at some point. The reasons for this are complex and multifactorial, and probably sociocultural and psychosocial. At the beginning of this century, popular drugs intended for non-medical users were diverted from prescription opioids. Then, it became the heroine. In recent years, it was heroin and fentanyl. Methamphetamine-related deaths now reach unprecedented levels, and preliminary estimates by the CDC place the number of methamphetamine-related deaths at nearly 13,000 in 2018, eclipsing the number of deaths from prescription opioids .
Senator Portman has two or three drugs late in his lawsuits against the war on drugs.
To bring down the death rate, Senator Portman should draw lessons from his home country, Ohio, where harm reduction measures have recently been adopted: expanding exchange programs of syringes, distribution of the antidote to overdose, naloxone, and increased access to drug-badisted treatment. according to preliminary data from the CDC, a 23.3% decrease in the number of overdose deaths in 2018. Harm reduction is a proven strategy to save lives.
If Senator Portman wants to develop legislation that can truly save lives, he should propose the repeal of the federal government's "Crack House" status. This law stands in the way of many of the country's largest cities that want to establish secure injection facilities, which are: preventing overdoses and saving lives in more than 120 cities across Europe, Canada and Canada. # 39; Australia.
This article is republished with the permission of the Cato Institute.
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