10/26/2015

YoungPeopleReceiveMorePainRelieversThanTheyNeed

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Anesthesiology2015fromtheAmericanSocietyofAnesthesiologists(ASA)

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YoungPeopleReceiveMorePainRelieversThanThey
Need
LairdHarrison

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Health,NotLaw
Enforcement,Issue
USPrescriptionOpioid
EpidemicEscalating

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SANDIEGOThereisanincreaseintheriskfordrugabuse
becausephysiciansprescribemoreopioidsthannecessaryto
controlchildren'spain,anewstudyindicates.

4. HowtoTalktoYourPatientsAboutSex
5. HowtoManageMusclePainin
PatientsonStatins
VIEWMORE

"Wehaveanethicalandmoraldutytotreatpain,butrightnow
wearedispensingmoremedicationthanweneed,"saidMyron
Yaster,MD,fromJohnsHopkinsHospitalinBaltimore.
IntheUnitedStates,thegatewaytodrugabuseisthe
nonmedicaluseofprescriptionopioids."Allthatleftover
medicationisleftinthemedicinecabinet.That'sacatastrophe
thatwe'recontributingto,"DrYastertoldMedscapeMedical
News.
HepresentedtheresearchhereatAnesthesiology2015.
DrYaster'steaminterviewed292parentsofpatients1to21
yearsofagewhoweredischargedintheprevious2dayswith
anopioidprescription,andinterviewedthemagain8to12days
later.

OpioidEquivalentsandConversions

Inthestudycohort,weightrangedfrom8.4kgto168.0kg,and
89%ofthepatientswereprescribedoxycodone(44%ina
liquidformulation).Fifteenpatients(5%)didnotfilltheirprescriptions,and71(25%)misidentifiedordid
notknowthenameoftheopioidprescribed.
Patientstookopioidsforanaverageof5days(range,013days).
Paincontrolwasratedasexcellentby47%ofpatients,goodby34%,
fairby10%,andpoorby0%paincontrolwasunratedby9%.
"Wedidagreatjobattreatingthepain,"DrYasterreported.On
average,however,patientsusedonly42%oftheirprescription.
Fourteendaysafterdischarge,anaverageof36.4tabletsremained
unused,asdid66.8mLofliquidopioids.

Allthatleftover

medicationisleft
inthemedicine
cabinet.That'sa
catastrophethat
we'recontributingto.

Butmostfamiliesdidn'tknowwhattodowiththeleftovermedication.
Only6%gotridofitattheendofthetherapy82%receivednoinformationonhowtodisposeofit.
That'saproblembecauseitcreatesa"bigstockpile"ofleftovermedication,saidoneofthestudy
researchers,AaronHsu,MHS,alsofromJohnsHopkins.Previousresearchhasshownthatfriendsand
familyarethemostcommonsourcesofillegallyobtainedmedication,hetoldMedscapeMedicalNews.
GatewaytoDrugAbuse
Inthisstudy,theaveragepatienthadonesibling,and46%hadasibling12yearsorolder."That
populationishighlysusceptibletodivertingthesedrugs,"heexplained.

http://www.medscape.com/viewarticle/853243?src=stfb

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10/26/2015

YoungPeopleReceiveMorePainRelieversThanTheyNeed

Isthisoverprescribing"relatedtothedifficultyofgettingaprescription,theregulatoryburden?"an
audiencememberaskedafterthepresentation.
DrYasterreportedthattheteamisconductingastudytofindoutwhydoctorsareprescribingmore
opioidsthantheirpatientsneed.Sofar,hesaid,acoupleofpossiblereasonshavebeenidentified
throughfocusgroups.
Surgeonsworrythatpatientswillrunoutofmedications,andwanttoeliminatethesecondcopayment
thatsomepatientshavetopayforarefill."Wedon'tknowifthesurgeonsrecognizethepublichealth
issue,"hesaid.
Theresearchersarealsoinvestigatingexactlyhowmuchofeachmedicationtheaveragepatientneeds
foragivenprocedure."Takesomethinglikeatonsillectomy,"saidDrYaster."Therearenodatatotell
youhowlongyouneedpaincontrol.Wehavetotailortheamountofdrugtowhatpatientsneed."
Itishardforpatientstodisposeofleftoveropioids,saidsessionmoderatorRobertWilder,MD,fromthe
MayoClinicinRochester,Minnesota.
DrYastersaidheagrees.TheUSFoodandDrugAdministrationadvisesthatleftoveropioidsbeflushed
downthetoilet,buttheEnvironmentalProtectionAgencywarnsthatthiscancauseharmfulpollution,he
said.
Somelawenforcementagencieswillacceptthem,butoftenatinconvenienttimesorplaces,saidDr
Wilder.Onesolutionmightbetorequirepharmaciestoaccepttheunuseddrugstheyhavedispensed,
hetoldMedscapeMedicalNews.
Anoxycodonepillsellsfor$60onthestreet,hesaid."Weoughttomakeiteasytogetridofthese
things."
Thestudywasnotfunded.DrYasterandDrWilderhavedisclosednorelevantfinancialrelationships.
Anesthesiology2015fromtheAmericanSocietyofAnesthesiologists(ASA):Abstract1056.Presented
October24,2015.
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MedscapeMedicalNews2015WebMD,LLC
Sendcommentsandnewstipstonews@medscape.net.
Citethisarticle:YoungPeopleReceiveMorePainRelieversThanTheyNeed.Medscape.Oct26,2015.

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