Opioid OD No Deterrent to Continued Prescribing

The Annals of Internal Medicine (Jan. 5th 2016) just published a study looking at opioid pain medicine overdose – which you would think would be a bit of a red flag and would make their doctor (or any doctor) think twice about continuing them on this kind of pain medicine.

Ah, but we have such high expectations of the medical profession.

 

The study was of of 2848 non-fatal opioid overdoses, of medicines like morphine, fentanyl, hydrocodone (as in Vicodin and Lorcet for example) or oxycodone (as in Percocet and OxyContin).

Such overdoses are “an opportunity to identify and treat substance use disorder” and “misuse of opioids and adverse effects are compelling reasons to discontinue opioids” note the authors of the study.

But the long term follow up of these ovedosers showed that 91% of them continued to get opiate prescriptions afterwards - in 70% of cases, from the very same doctor who prescribed them in the first place.

“What the hell’s wrong with these doctors?” you might be tempted to ask.

I could introduce to quite a lot of doctors who have bad judgment (it always intrigues me – someone can go through the whole, protracted medical education thing and still turn out a doozy, lacking common sense).

But what really caught my attention about this study was the comment by lead author Dr. Marc Rochelle of Boston University School of Medicine that “some prescribers may have been unaware that the opioid overdose occurred.”

The doctor blithely went on prescribing opiates for these patient’s, but that they didn’t know the patient had overdosed.

Tell me that’s not an indictment of the state of communications within the healthcare industry? *

*Doctors and hospitals are all being mandated to implement electronic medical records – to facilitate such communication. But the claim is healthcare is a decade behind the rest of the world in their IT technology because there’s some 150 different vendors all trying to develop their own system – which they jealously guard, and will not share with the competition. So there are zillions of different systems that won’t talk to each other. It’s like the Tower of Babel.

 

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