Is co-prescription of naloxone with painkillers the answer to opioid epidemic?

Is co-prescription of naloxone with painkillers the answer to opioid epidemic?

The effects of addiction are devastating. Dependence does not stem only from the use of psychotropic drugs or alcohol, even overdose or abuse of prescription painkillers can lead to cravings which may be difficult to contain if not treated during initial stages.

Opioid, when discovered, was touted as a miracle drug that helped alleviate pain by sticking to opioid receptors in the body. Effects of their overdose or misuse were never considered. This resulted in excess of prescriptions for painkillers that produced pleasurable emotions coupled with difficulties in breathing. If taken in substantial quantity, the same can even cause death.

Unintended overdose or taking painkillers like hydrocodone (in Vicodin) or oxycodone (in Percocet) in a manner not prescribed is one of the leading causes of preventable deaths in the U.S. According to the Centers for Disease Control and Prevention (CDC), there has been a rise in opioid overdose deaths by 200 percent since 2000. In 2014, 28,647 Americans succumbed to opioid-related deaths.

As per the American Society of Addiction Medicine (ASAM), 467,000 teenagers had used pain relievers for non-medical reasons in 2014, of which 168,000 were addicted to prescription opioids. The same was attributed to sharing of leftover opioids by people unaware of the detrimental impact of non-medical opioid use.

Prescribing naloxone with opioids

To tackle the epidemic, doctors suggested prescribing naloxone or Narcan along with opioids to patients. Naloxone, used as a nasal spray or a muscular injection, reverses the impact of opioid on the brain that helps in saving patients of drug overdose.

In a recent study, a group of scientists examined the practicality and impact of administering naloxone prescription to patients recommended painkillers for acute pain. The scientists in their study, titled “Nonrandomized Intervention Study of Naloxone Coprescription for Primary Care Patients Receiving Long-Term Opioid Therapy for Pain,” looked at the possible advantages of co-prescribing naloxone with opioids.

For research purposes, the doctors prescribing opioids to treat long-term pain informed their patients about the potential risks of overdose apart from teaching them how to use naloxone. For the two-year non-randomized intervention study, published online in the Annals of Internal Medicine in June 2016, the researchers provided training to staff working at six clinics in the San Francisco area on how to co-prescribe pain relievers and naloxone.

The researchers observed 1,985 adults and tried to find if co-prescription of opioids and naloxone resulted in reduced emergency visits linked to use of opioids and if there was any change observed in the dosage of prescription opioids. The observations were:

  • Number of naloxone prescriptions increased as more providers were trained to administer naloxone. Apart from this, some doctors exhibited their willingness to co-prescribe.
  • Patients who had been overdosing on opioids or had to be treated in the emergency department during the previous year for opioid misuse were at a greater likelihood of being prescribed naloxone.
  • When compared to people who had not been recommended any naloxone prescription, there was 47 percent decrease in emergency room department visits each month in the next six months for those who had been co-prescribed naloxone.
  • Naloxone showed no impact on prescription opioids.

The findings indicated that co-prescription of naloxone may help in reducing the possible adverse effects associated with opioid misuse. The willingness of doctors to prescribe naloxone with opioids proved to be an added advantage. The study observed that a comparatively brief training for providers resulted in a third of patients on opioids getting naloxone.

Recovery road map

If you or your loved one is addicted to antidepressants or any other prescription drug and is looking for treatment, contact the Prescription Drug Abuse Helpline of California for information on various prescription drug rehabs in California. Call us at our 24/7 helpline number 855-738-2770 or chat online for further information on prescription drug addiction treatment in California. Our representatives will guide you through the best rehab centers in California.

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