We commend the Missouri health care organizations that have joined to address the abuse and misuse of opioid painkillers.
Opioids are an effective option to treat pain in some medical cases, but patients may become dependent and exceed the prescribed dosage.
The Missouri Hospital Association (MHA), one of the six medical groups, cited state research that found "hospital treatment for commonly prescribed opioid painkillers - where overuse is a primary or contributing factor for inpatient or emergency care - increased 137 percent in Missouri between 2005-15."
MHA also noted, "Separate research suggests a strong link in opioid abuse and heroin addiction, and submits as many as three out of four prescription opioid abusers will eventually use heroin as a less expensive source of opioids."
To address this growing concern, the groups endorsed 10 recommendations, to be adopted as a standalone policy or in addition to existing, effective strategies.
Recommended policies include:
• Conducting a focused pain assessment that includes risk factors for addiction and inclusion of non-narcotic analgesics.
• Limiting opioid prescriptions for chronic conditions to no more than 72 hours, if clinically appropriate.
• Restricting opioid prescriptions for new conditions to "the shortest duration needed that effectively control the patient's pain."
• Instructing emergency department physicians to be circumspect when patients claim narcotic prescriptions have been lost or destroyed.
In addition to MHA, the recommendations have been endorsed by the Missouri Academy of Family Physicians, Missouri Association of Osteopathic Physicians and Surgeons, Missouri College of Emergency Physicians, Missouri Dental Association and Missouri State Medical Association.
Patients in chronic pain may require opioid painkillers to lead active, productive lives. But opioids are addictive, and misuse can lead to the powerful disease of addiction. When that happens, evidence shows heroin often becomes a more easily available and less expensive alternative.
Opioid use must be prescribed and monitored with great care, because misuse of the treatment can create additional harm.
We thank the medical groups for embracing additional precautions about the use of opioid painkillers.