Health Insights: Reducing opioid abuse

As the opioid epidemic continues to spread across the country, Texas is taking some important steps in the battle, from improved monitoring of prescription painkillers to expanded programs to treat addiction. But as UT Southwestern pain management expert Dr. Carl Noe explains, the crisis cannot be solved until we educate more physicians and the public about real alternatives to these addictive pills.

If your doctor told you that this medicine could help your pain, but it also has significant risk of overdose or becoming dependent, you would probably choose to avoid that.

We now have approximately 16 million Americans who take opioids on a daily basis for chronic pain.

In Texas, there are over a thousand opioid related deaths per year, and this is a sign of a significant epidemic and we need to combat this epidemic by prescribing fewer opioids at lower doses and for shorter periods of time. Also, we need to focus on opioids that are non-prescription opioids such as fentanyl that is coming into this country illegally and heroine which is having a resurgence and contributing to the problem.

If you have depression or anxiety, you may have higher risk for becoming dependent on these medications because they do have effects on the brain besides just pain relief.

If you have a family history…or if you have a personal history of addiction, that’s a risk factor.

One of the most important things for physicians to do is to stop prescribing opioids as a first-line therapy. It has become the expectation among patients to receive opioid prescriptions for acute pain or minor pains when this pain may be able to be managed without opioids at all. 

From a medical standpoint, we need to go back to data and evidence-based medicine. There is a new trial about chronic opioid therapy that actually showed that patients who were treated with non-opioid medicines actually had less pain than patients who were treated with opioids. This is a huge step forward in our knowledge base.

I think the low hanging fruit in all of this is educating patients about the risk of these medications.

Most patients do not have trouble discontinuing opioids, but a lot of us do and we need to be aware of that and help people tapper of these medications and stop them like we would an antibiotic rather than treating patients for as long as the pain persists.