What to Do When Your Doctor Gives You or A Loved One a Prescription for Opioids
It still happens.
We are in the middle of an opioid crisis. However, there is still a tendency for some physicians to automatically write a prescription for opioid medications “just in case.” Often it can be for back pain or dental surgery or a sports injury. What should you do when confronted with this scary script?
1. Understand that pain medication, primarily opioids such as hydrocodone, oxycodone, codeine and morphine, is highly addictive.
The public has only recently learned how addictive opioids are following the deaths of thousands and thousands of Americans who were originally written a prescription for pain. Seventy five percent of people who began abusing opioids in the last two decades started their addiction with a prescription drug, as compared to those who began an addiction in the 1960s when heroin was the drug that most often led to an opioid addiction. According to SAMHSA, 11.8 million people (age 12 or older) misused opioids in the past year. The vast majority misused prescription opioids; only 2.6 % used heroin without other prescription opioids
Thus, prescription opioid use, even when prescribed by a doctor, can lead to a substance use disorder. Withdrawal symptoms include muscle and bone pain, sleep problems, diarrhea, vomiting, and severe cravings. Thus, any prescriptions for opioid drugs prescribed by your doctor should at least raise a question in your mind.
2. Check out the government’s guidelines on when these addictive opioid drugs should be prescribed for pain.
Opioid pain medication should not be the first choice of pain relief for most conditions. Evidence supports the use of acetaminophen, aspirin, and ibuprofen, as well as physical therapy, exercise, acupuncture, meditation and yoga for pain management as effective for most pain.
Earlier this year, on February 28, 2019, the Center for Disease Control (CDC) Chief Medical Officer Deborah Dowell, MD, MPH reiterated and clarified the CDC’s intentions around opioid prescribing guidelines, issued in 2016. These guidelines recommended nonopioid pain management approaches including physical therapy as a preferred first-line treatment for some—but not all—types of chronic pain. Types of pain deemed appropriate for initial opioid use included only cancer treatment, palliative and end-of-life care. Further, the guidelines stated that doctors should prescribe opioids ONLY when the benefits for pain and function are expected to outweigh the risks.
3. If your doctor does prescribe pain medication for you or a loved one, question your doctor on why they are choosing an opioid.
The U.S. Food and Drug Administration published a checklist for patients to ask their doctors BEFORE filling an opioid prescription which includes the following questions:
- Are there non-opioid alternatives that could help with pain relief while I recover?
- How long should I take this medication?
- How can I reduce the risk of potential side effects from this medication?
- What if I have a history of addiction with tobacco, alcohol or drugs?
- What if there is a history of addiction in my family?
- Could this treatment interact with my other medicine for anxiety, sleeping problems, or seizures?
- Can I share this medication with someone else? Why not?
- How should I store my opioid medication to prevent other people from taking it?
- What should I do with unused opioid medicine? Can I have an Rx for naloxone?
- Why do I need this medication—is it right for me?
- Utilizing some of the questions on this checklist will bring into focus whether a prescription for opioids is really needed.
4. Don’t fill the prescription “Just in Case;” only fill it if you need this level of pain relief.
Many patients, when a doctor hands them a prescription for pain pills, will fill it even if they plan to use it as a last resort. However, that’s a bad idea. Keeping highly addictive drugs in the medicine cabinet “just in case” is a dangerous practice. According to SAMHSA, more than half of individuals misusing prescription opioids bought, were given, or stole the prescription drugs from a friend or relative, often from the home medicine cabinet.
Additionally, keeping opioid drugs in your home is bad for the environment. According to the DEA analysis, between 2006 and 2012, drug companies saturated our country’s pharmacies with over 76 billion oxycodone and hydrocodone pills. Often, the opioid pills prescribed for post-surgical use are leftover and unused. These drugs need to be deactivated and destroyed and then disposed of — not only to prevent misuse and addiction– but also because these extra pills create an environmental hazard. Flushing pills down the toilet or sink and mixing with other substances like kitty litter do not meet the “non-retrievability” standard for safe disposal and can poison our water supply.
Please contact your local Township for suggested methods of safe disposal of your unwanted drugs, including local “dropoff” boxes, and National Takeback Day.