This country's growing heroin epidemic is not, as one might assume, the effect of an illegal "gateway drug" such as marijuana, but rather, an offshoot of addiction to legally prescribed pills. Statistics show that people who are addicted to opioid painkillers are 40 times more likely to be addicted to heroin.
On Tuesday, the federal government published its first-ever national guidelines for doctors prescribing opioid painkillers. The report, released by the Centers for Disease Control and Prevention (CDC), recommends that primary care clinicians try pain relievers like ibuprofin first, and that they prescribe only a few days' worth of opioids when necessary, the New York Times reports. (The guidelines do not apply to active cancer treatment, palliative care or end-of-life care.)
Opioids, a class of drugs used to reduce pain, include medications such morphine, methadone, and oxycodone and hydrocodone - also known by the brand names OxyContin, Vicodin and Percocet - as well as street drugs like heroin and fentanyl, a synthetic opioid. Almost 2 million Americans abused or were dependent on opioid painkillers in 2014, and 28,647 died of an opioid overdose that same year.
"We know of no other medication routinely used for a nonfatal condition that kills patients so frequently," said CDC director Thomas Frieden.
The Times reported that practices developed 20 years ago have contributed to the nation's love affair with painkillers. That's when doctors in the U.S. began prescribing opioids to treat conditions as common as back pain and arthritis.
"In the 80s and 90s there was a big push in the medical community to treat pain, and it was this feeling that we weren't being aggressive enough about it so doctors went a little bit overboard," said Tara Narula, MD, in an interview with CBS This Morning. "In addition, the drug companies then were marketing opioids as being safe, non-addictive and misleading the medical community in many ways. Doctors weren't being well trained on the addictive potential."
The new guidelines, which are voluntary, suggest doctors prescribe painkillers only after considering non-addictive pain relievers, behavioral changes and other options, CBS reports. Even then, the CDC says the prescription should be for the lowest effective dose possible and should only be renewed if patients show significant improvement.
"We're trying to chart a safer and more effective course for dealing with chronic pain," Frieden told the Associated Press. "The risks of addiction and death are very well documented for these medications."
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