More than 10 years ago, I wrote a commentary in The Rheumatologist, called “Perils of Pain Meds,” about the over-prescribing of opioid analgesics for common causes of chronic noncancer pain, which was a major contributor to the opioid epidemic.1 Since that time, although there has been a greater than 20% decrease in opioid prescribing, the…
Ethics Forum: What to Do with the Inherited Opioid Patient?
A 67-year-old man with a recent onset of diffuse muscular pain and stiffness and an erythrocyte sedimentation rate of 55 is referred to you by his family practitioner. He has a history of non-insulin-dependent diabetes mellitus, but no history of headaches or swollen joints. He has chronic back pain, has had two surgeries and was…
Can Rheumatologists Get More Systematic about Psychosocial Care?
A recent position statement by the Society of Behavioral Medicine (SBM) concludes that patients with persistent pain need better access to psychosocial care in all healthcare settings.1 The SBM offers 10 health policy recommendations for improving such access, including removing system-related barriers, providing referral tools, reimbursing for evidence-based psychosocial approaches, prioritizing generalist-level and specialist pain…
Opioid Refusals: How to Deal with the Angry or Hostile Patient
In July 2017, Todd A. Graham, MD, a practicing orthopedic surgeon in South Bend, Ind., was fatally shot after getting into a heated dispute with a patient and her husband over a requested opioid prescription.1 The murder of Dr. Graham is a tragic example of the potential dangers of physician-patient disagreements. Rheumatology patients often endure…
Opioid Makers Paid Millions to Advocacy Groups
(Reuters)—Five opioid manufacturers, including OxyContin maker Purdue Pharma LP, have paid more than $10 million to advocacy groups and doctors tied to them, many of whom amplified industry messages supporting the use of the painkillers, a U.S. Senate report said on Monday.1 The report, released by Sen. Claire McCaskill (D-Mo.), says groups who received the…
Delaware Sues Opioid Manufacturers, Distributors Over Epidemic
(Reuters)—Delaware on Friday became the latest state to file a lawsuit accusing corporations of helping fuel the national opioid epidemic, suing a wide range of companies involved in making, distributing and selling prescription painkillers.1 The lawsuit, filed by Delaware Attorney General Matt Denn in a state court, targeted drugmakers Purdue Pharma LP and Endo International…
Kentucky Accuses McKesson of Helping Fuel the Opioid Epidemic
(Reuters)—Kentucky’s attorney general on Monday accused drug distributor McKesson Corp. of helping fuel the opioid epidemic by failing to halt shipments of suspiciously large or frequent orders by pharmacies of prescription painkillers. The complaint by Kentucky Attorney General Andy Beshear was filed in a state court and was one of a flurry of lawsuits by…
Wal-Mart Launches Program to Safely Dispose of Unused Opioids
NEW YORK (Reuters)—Wal-Mart Stores Inc on Wednesday said it will provide customers filling prescriptions for opioids with a packet of powder that will help them dispose of leftover medication in order to help curb misuse and abuse. The company said patients filling any new class II opioid prescriptions at its pharmacies will receive a free…
Neurontin Prescriptions Surge Amid Opioid Crisis
(Reuters Health)—Prescriptions for nerve pain medicines like Neurontin and Lyrica have more than tripled in recent years, driven by increased use among chronically ill older adults and patients already taking opioids, a U.S. study suggests. The proportion of U.S. adults prescribed Neurontin and other drugs in the same family of medicines climbed from 1.2% in…
U.S. Life Expectancy Fell in 2016 as Opioid Overdoses Surged—CDC
NEW YORK (Reuters)—Life expectancy in the United States dipped in 2016 as the number of deaths due to opioid drug overdoses surged and total drug overdose deaths rose 21% to 63,600, the U.S. Centers for Disease Control and Prevention said on Thursday. Life expectancy fell to 78.6 years, a decrease of 0.1 year from 2015,…