March 15--Federal regulators announced new guidelines for narcotics Tuesday, telling doctors to try to minimize opioid prescription drugs except in the most severe cases.
The U.S. Centers for Disease Control and Prevention issued the new recommendations to quell what it called an epidemic of prescription drug overdose deaths. Prescriptions and sales of opium-derived painkillers such as Oxycontin, hydrocodone and fentanyl have quadrupled since 1999, and overdoses kill more than 40 Americans a day on average.
The 12 recommendations are based on three primary principles: using non-narcotic drugs except to treat active cancer and for palliative and end-of-life care; using the lowest effective dose of opioids; and close monitoring of patients.
Dr. Asokumar Buvanendran at the Rush Pain Center in Chicago gave input on the recommendations recently in a letter to the CDC.
He said physicians need to be made more aware of alternatives to opioids, such as epidural injections, radio frequency denervation and spinal cord stimulation. These treatments directly address and block pain where it occurs, unlike opioid painkillers, which affect the entire body.
Buvanendran, who is vice chairman of the American Society of Anesthesiologists Committee on Pain Medicine, said the safety and effectiveness of such opioid alternatives must be clearly conveyed and that insurance companies should cover them.
"Used appropriately, opioids are an important tool in treating pain," he said in a statement. "But there are very many safe, non-pharmacological and non-opioid pharmacological therapies proven to be as or more effective than opioids that don't carry the risk of dependence."
rmccoppin@tribpub.com
