Importance of Opioid Prescribing Training
Opioid abuse is a public health crisis. According to the Centers for Disease Control and Prevention, Opioids (including prescription opioid pain relievers and heroin) killed more than 28,000 people in 2014, more than any year on record. At least half of those deaths involved a prescription opioid.
Many medical schools have already made changes to their curriculum in response to this growing epidemic. According to Atul Grover MD, PhD, chief public policy officer at the Association of American Medical Colleges (AAMC) and moderator of a January 28 Capitol Hill Briefing titled “How Medical Schools and Teaching Hospitals are Addressing the Opioid Epidemic”, the response is ever evolving in this epidemic the same way medicine and education evolves.
Harvard Med, however, is worried that if they take a pledge requiring students to learn new federal guidelines for safely prescribing opioids, there is no telling how some groups may react. According to Harvard Dean, Dr. Jeffrey Flier, this could “be the death of higher education.” Read more at: https://www.statnews.com/2016/05/17/opioid-addiction-medical-schools/
According to Dr. R. Lee Irvin, MD, Diplomate of the American Board of Anesthesiology with specialty certifications in Anesthesiology and Pain Medicine, and a member of the American Medical Association, American Society of Interventional Pain Physicians, among others, he explains that “opioids and other prescription sedatives are prescribed and taken much too often and at higher doses than generally necessary for for far to long of a time. Various government agencies are now proposing strict restrictions on prescribing methods of doctors, along with closer scrutiny of patients who are on long term opioid medications. Through efforts of fundamental education for doctors in training, as well as efforts to educate patients and doctors who are currently in practice, hopefully an even balance can be reached between providing necessary medications to those who are really in need, while at the same time, reducing excessive utilization of narcotics and other central nervous system depressant drugs. Perhaps in this manner the number of prescription drug overdose death’s can be reduced, and at the same tim,e patients in need will be able to access appropriate medications. Medical school training should also particularly include drug interactions, it has been shown that a combination of medications, (benzodiazepine such as valium) can be particularly dangerous when mixed with opioids.”
Medical students should be careful of harmful habits, like over prescribing drugs. Students should also be fully cognizant of the long-term effects of these drugs on patients. The head of the White House Office of National Drug Control Policy, Michael Botticelli, observed that the number of people who die of overdoses in each state is closely linked to how widely doctors are prescribing opioids. He states, “We are over 10 years into this epidemic, and I don’t think we’ve seen a robust enough response from the medical community.”
Thankfully, in the last 10 years, the evolution of the Prescription Drug Monitoring Program has been able to give healthcare providers a database to search their patients to identify drug-seeking behavior, and avoid harmful drug interactions. The program also gives our law enforcement the ability to monitor a clinician’s prescribing and dispensing behavior.
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