Doctors' Group Issues Painkiller Guidelines

Narcotics too risky in many cases, American Academy of Neurology says

MONDAY, Sept. 29, 2014 (HealthDay News) -- The risks of powerful narcotic painkillers outweigh their benefits for treating chronic headaches, low back pain and fibromyalgia, a new statement from the American Academy of Neurology says.

Narcotic, or opioid, painkillers include medications such as morphine, codeine, oxycodone (Oxycontin), methadone, fentanyl, hydrocodone or a combination of the drugs with acetaminophen.

The drugs can cause serious side effects, overdose, addiction and death. Research shows that 50 percent of patients who took opioids for at least three months are still on them five years later, according to the academy.

Studies find that while opioids may provide short-term pain relief, there is no proof that they maintain pain relief or improve patients' ability to function over long periods of time without a serious risk of overdose, dependence or addiction, the statement says.

"More than 100,000 people have died from prescription opioid use since policies changed in the late 1990s to allow much more liberal long-term use," Dr. Gary Franklin, of the University of Washington in Seattle, said in an academy news release.

"There have been more deaths from prescription opioids in the most vulnerable young to middle-aged groups than from firearms and car accidents," he added. "Doctors, states, institutions and patients need to work together to stop this epidemic."

Doctors should consult with a pain management specialist if a patient's daily opioid dosage reaches 80 milligrams to 120 milligrams, especially if the patient isn't showing substantial improvement in pain levels and physical function, the statement advises.

The statement, published in the Sept. 30 issue of the journal Neurology, also outlines ways for doctors to prescribe opioids more safely and effectively. These suggestions include: screening for depression and current and past drug abuse; creating an opioid treatment agreement with the patient; and using random urine drug screenings.

"More research and information regarding opioid effectiveness and management is needed, along with changes in state and federal laws and policy to ensure that patients are safer when prescribed these drugs," Franklin said.

More information

The American Academy of Family Physicians has more about chronic pain medicines.

Robert Preidt

Robert Preidt

Published on September 29, 2014

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