Living Well America is in the middle of another epidemic.
You've likely seen headlines about the opioid crisis. Overdose deaths hit new highs and police now carry the antidote drug naloxone with them.
Ohio made headlines for suing drugmakers. The lawsuit claims Big Pharma knowingly misled folks on the dangers of opioid drugs.
According to the latest data published in JAMA, doctors wrote 70.6 prescriptions for opioids for every 100 persons. Now, that doesn't mean 71% of Americans got a prescription for some sort of opioid. It means total prescriptions written, which represents part of the problem: Doctors wrote multiple prescriptions per person. Worse, depending on which state you live in, you could see even higher rates reaching into the 100s... that's why places like Ohio, Kentucky, and Mississippi are hit the hardest by this epidemic.
Opioids act as powerful painkillers and include oxycodone, codeine, hydrocodone, and fentanyl. Brand names include OxyContin and Vicodin.
Some experts point out that this is a decline from the 81.2 prescriptions per 100 people rate we hit between 2010 and 2012. But that's misleading, as our prescription rate is three times higher than in 1999.
And it's an American problem... we still have a four times higher rate than Europe.
Overprescribing opioids has two major problems... First, they are only meant for short periods of pain relief (think post-surgery pain). Second, they're highly addictive. And the longer you take opioids, the higher your risk of overdose, death, and addiction. The average time spent taking prescriptions is 17.7 days. And a few sources indicate that taking an opioid for just 90 days significantly increases your chances of addiction.
Researchers estimate the number of drug overdose deaths hit at least 60,000 in 2016 (final data won't be out until December of this year).
Seniors aren't immune from the problem. In 2009, the American Geriatric Society (AGS) stated opioids are good choices for older folks because they're less likely to become addicted.
That's not only false, but puts seniors at much higher risk for long-term side effects. These include a weakened immune system, altered hormones, dependency, and overdose.
According to the Healthcare Cost and Utilization Project, in the past 20 years the number of seniors admitted to the hospital for opioid-related problems rose five-fold. (The AGS has since rescinded that guideline.)
Doctors overprescribe opioids despite their dangerous side effects. The overprescription problem is so bad, the FDA is now considering mandatory opioid training for physicians.
Now, we understand that in some cases, opioids are necessary. A few of my researchers have taken them for various problems. But you must protect yourself and your loved ones if a doctor suggests writing a prescription.
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What to Ask If Your Doctor Prescribes an Opioid
If you or a loved one are getting a prescription for an opioid, you must do what we always suggest for any medication: Understand why you're taking it, how long you should take it, and when you can stop. Once you understand those basics, move on to these opioid-specific questions:
1) Are there any non-opioid medications or alternate therapies I can try? We've written extensively about other pain-management techniques, including yoga, massage, and meditation (you can read the full back pain report here). Deep breathing also helps lower stress and alleviate tension and pain. Make sure to investigate every possibility before taking an opioid.
You can even consider combining these therapies with a low dose of opioids. Not only will it keep your intake low, but may help you taper off and quit taking the medication altogether. Check with your doctor about how slowly you should wean yourself off. Different strengths and types of opioids have different recommendations, so make sure you know exactly what to do and when to do it.
2) Do you have a contract for opioids? The contract is a new monitoring method some doctors now employ. It involves seeing the patient in person to renew the prescription, pill counting, and only staying with that doctor. Unfortunately, when some folks get addicted to opioids, they "shop" around and get prescriptions from multiple doctors. Ensuring that only your primary care doctor is the one approving your medications is another step toward safety.
When you get the prescription, be up front with your doctor. Talk about any family medical history of addiction (including alcohol) and create a monitoring plan together. Sharing that accountability will help.
3) If the pain isn't manageable with short-term opioids, ask to see a specialist. Opioids are designed for short-term use only. If you have chronic pain like chronic lower back pain or fibromyalgia, opioids may bring minimal relief over time. Seeking out a pain specialist could be a better option for you.
Furthermore, if an elderly parent gets a prescription, consider a memory screening. Even early memory loss makes folks forget if they took their pills, which sometimes leads to overdose.
Remember too, folks without a diagnosed mental illness still struggle with dependency, so ask your doctor to refer you to a psychological provider if needed.
Opioid addiction and death is a major problem. But reducing the number of prescriptions has only just started to help. Take control of your own life and educate yourself on what to do. Make a plan and have your doctor hold you accountable.
What We're Reading...
- Read more about deep breathing for pain relief.
- NPR details a senior's struggle with dependency.
- Something different: Excuse me, are you my mother?
Here's to our health, wealth, and a great retirement,
Dr. David Eifrig and the Retirement Millionaire Daily Research Team
July 11, 2017
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