Opioid Prescriptions During the Opioid Epidemic: Challenges and Guidelines

Despite the ongoing opioid epidemic, doctors in the United States still prescribe opioids, albeit with significantly enhanced caution and adherence to updated guidelines. The opioid crisis has starkly highlighted the risks associated with opioid misuse and has prompted a more rigorous approach to prescription practices.

Prescription Practices during the Opioid Epidemic

No doctor in the USA will prescribe an opiate without an in-person appointment and examination. This stringent requirement ensures that a medical professional can properly assess the patient's condition and history, thereby reducing the risk of potential misuse.

It is also highly unlikely that you will receive an opiate prescription unless you are a patient who sees the doctor on a regular basis. Severe pain sufficient to necessitate opiate use often requires close medical supervision and ongoing care.

In the past, it was less uncommon for doctors to prescribe opioids based on a patient's request alone. However, these days, the risks associated with such practices have led to a more cautious approach. Doctors understand the potential for addiction and the harmful consequences of improper use.

The Risks of Opioid Misuse

Street-level transactions with so-called 'drug dealers' are filled with risks, including physical violence and the potential for counterfeit or toxic substances. Reputable medical practitioners are not only trained to measure and monitor pain but also to identify signs of misuse and addiction. In contrast, drug dealers often base their 'assessments' on a 'looks good to me' approach, where the potential for harm is much higher.

The cartels, while aiming to maximize profits, have realized that the loss of clients negatively impacts their bottom line. However, street-level 'suppliers' frequently cut drugs to minimize their own losses, leading to unpredictable outcomes. The result is a dangerous and often fatal scenario, especially when mixed with contaminants like fentanyl.

Current Trends in Opioid Prescribing

While the use of opioids has declined overall, the situation varies depending on the context and region. In the U.S., there has been a clear reduction in opioid prescriptions, with some hospitals refusing to prescribe them even in cases of severe pain. However, this trend is not uniform, and there are still instances where opioids are prescribed, especially when other treatments are ineffective.

In some regions, particularly in Canada, the situation is slightly different. Getting a doctor to prescribe anything stronger than Codeine (percocet) can be a lengthy process that involves significant 'dr. shopping' and a higher likelihood of being prescribed methadone, a substance often used in the treatment of opioid addiction. This highlights the varying approaches to pain management and the challenges faced by healthcare providers in balancing the need for effective pain relief with the risks of opioid use.

Conclusion

The opioid epidemic has significantly impacted medical practices, leading to a more cautious and guided approach to prescribing opioids. While the risk of misuse and addiction remains, the benefits of controlled pain management using these medications must also be considered. The situation varies widely, and ongoing education and guideline adherence are crucial in addressing the complexities of this ongoing public health issue.