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A moral dilemma amidst a never-ending war on drugs

A moral dilemma amidst a never-ending war on drugs

on Nov 20, 2017by Rachaelin Opioid abuse

Opioids, an important tool for physicians and one of the most effective drugs for treating chronic pain and suffering, are widely associated with abuse and addiction. Although not effective for all, opioids can help make life manageable.

One of the central issues surrounding opioid prescriptions is the problem of morally prescribing opioids. Oftentimes, physicians face the dilemma whether opioids should be used at all. In fact, one of the challenges confronting the society is how to reduce opioid prescription without harming patients.

Though physicians bear the responsibility of carefully prescribing opioids to the patients based on their assessment, they need to exercise caution to avoid legal sanctions for improper opioid prescriptions. As a result, medical practitioners are constantly in the state of confusion.

On one hand is the physician’s obligation to provide the patient relief from pain, and on the other are the unintended consequences resulting from opioid use and misuse. Such ethical challenges have led to a massive increase in the opioid crisis. Therefore, the need of the hour is to constitute guidelines on the entire process of prescribing opioids to combat the problem.

Moving away from opioids: Suitable alternatives

Considered an important component in the long-term treatment for acute, surgical and post-traumatic pain, moving away from opioid therapy abruptly can be harmful to the patients and might cause a relapse.

Owing to their addictive nature, painful withdrawal symptoms and overall negative health consequences, it is often recommended to find suitable and feasible alternatives to opioids. Some of those methods include placebo therapy, tapering chronic pain patients off opioids, conservative treatment methods like physical therapy or home exercise programs, and more advanced treatment options like nerve blocks and pain pumps.

While prescribing opioids as per the clinical guidelines can ensure access to safer and more effective pain treatment options, it can also help reduce the number of people abusing, misusing or overdosing on these drugs.

In an attempt to limit the over prescription of opioids, the Centers for Disease Control and Prevention (CDC) published Guideline for Prescribing Opioids for Chronic Pain providing recommendations for prescribing opioid pain medication, including starting with the lowest effective dose, using opioids only when their benefits outweighed risks, reexamining the benefits of opioids while considering dosage increase, etc.

Some of the ways by which clinicians may work toward responsible opioid prescription are as follows:

  • Prescribing opioids only when appropriate: In cases where the patients can be helped via the use of physical therapy, exercise and alternative therapy, physicians should employ non-opioid management strategies, non-pharmacologic therapy and non-opioid pharmacologic therapy when necessary.
  • Offering necessary care: While prescribing opioids over long term, physicians must be willing to manage prescriptions that they write and should also collaborate with others to ensure patients receive necessary care.
  • Prescribing not more than the requirement: When prescribing opioids, physicians should not write for more than what is needed. In addition, physicians should include a plan of care that includes an ‘exit strategy’ to get off the medication, if needed.
  • Addressing risks and harms of opioid use: An effective way to prevent opioid misuse is by conducting an open discussion between the provider and the patient about the benefits and risks of using opioids, awareness of their side effects, and a basic understanding of addiction.

While opioids have long been considered effective and necessary in managing chronic pain, no single drug stands out to be the best at managing chronic pain. Until the time physicians are unable to find effective alternatives to opioids, physicians should resort to alternative pain control methods, open communication with patients and thoughtful prescriptions to reduce the risks related to opioid abuse.

Responsible prescribing lessens opioid abuse risks

While opioid usage continues to be high among people suffering from chronic pain conditions, its long-term use inflicts several side effects and causes addiction among the users. In addition to damaging the user’s physical and mental health, those abusing opioids are also likely to experience problems in their personal and professional lives. The increased cost borne by the users due to the frequent and persistent abuse of opioids also affects their finances.

If you or your loved one is suffering from opioid abuse, it is time to seek professional treatment. Contact the Prescription Drug Abuse Helpline at 866-450-1557 to find the state-of-the-art prescription drug abuse treatment clinic. Alternatively, you can chat online and let our counselors help you find the best prescription drug abuse treatment centers.

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