{"id":1767511,"date":"2022-12-08T07:47:42","date_gmt":"2022-12-08T12:47:42","guid":{"rendered":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/?p=1767511"},"modified":"2022-12-08T10:34:55","modified_gmt":"2022-12-08T15:34:55","slug":"doctors-weigh-in-on-the-right-way-to-stop-prescribed-opioids","status":"publish","type":"post","link":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/doctors-weigh-in-on-the-right-way-to-stop-prescribed-opioids\/","title":{"rendered":"Doctors Weigh in on the Right Way to Stop Prescribed Opioids"},"content":{"rendered":"<aside class=\"mashsb-container mashsb-main mashsb-stretched\"><div class=\"mashsb-box\"><div class=\"mashsb-count mash-medium\" style=\"&quot;\"><div class=\"counts mashsbcount\">22<\/div><span class=\"mashsb-sharetext\">SHARES<\/span><\/div><div class=\"mashsb-buttons\"><a class=\"mashicon-facebook mash-medium mash-nomargin mashsb-noshadow\" href=\"https:\/\/www.facebook.com\/sharer.php?u=https%3A%2F%2Fwww.conservativenewsdaily.net%2Fbreaking-news%2Fdoctors-weigh-in-on-the-right-way-to-stop-prescribed-opioids%2F\" target=\"_top\" rel=\"nofollow\"><span class=\"icon\"><\/span><span class=\"text\">Facebook<\/span><\/a><a class=\"mashicon-twitter mash-medium mash-nomargin mashsb-noshadow\" href=\"https:\/\/twitter.com\/intent\/tweet?text=&amp;url=https:\/\/www.conservativenewsdaily.net\/breaking-news\/?p=1767511&amp;via=ConservNewsDly\" target=\"_top\" rel=\"nofollow\"><span class=\"icon\"><\/span><span class=\"text\">Twitter<\/span><\/a><a class=\"mashicon-subscribe mash-medium mash-nomargin mashsb-noshadow\" href=\"#\" target=\"_top\" rel=\"nofollow\"><span class=\"icon\"><\/span><span class=\"text\">Subscribe<\/span><\/a><div class=\"onoffswitch2 mash-medium mashsb-noshadow\" style=\"display:none\"><\/div><\/div>\n            <\/div>\n                <div style=\"clear:both\"><\/div><\/aside>\n            <!-- Share buttons by mashshare.net - Version: 4.0.47--><p><span>Opioid addiction and the illness and death associated with the misuse of these drugs is a growing health crisis.<\/span><\/p>\n<p><span>Last year, the <\/span><a href=\"https:\/\/www.cdc.gov\/nchs\/pressroom\/nchs_press_releases\/2021\/20211117.htm\"><span>Centers for Disease Control and Prevention<\/span><\/a><span> (CDC) made headlines with news that 2021 saw an unprecedented number of overdose deaths from opioid use.\u00a0\u00a0<\/span><\/p>\n<p><span>Although these drugs can offer relief for people with chronic pain or who have experienced surgery, they do come with risks, particularly opioid use disorder (OUD)\u2014the chronic use of <a href=\"https:\/\/www.theepochtimes.com\/t-opioids\">opioids<\/a> that causes \u201c<\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK553166\/\"><span>clinically significant<\/span><\/a><span>\u201d distress or impairment, including dependence and even addiction to opioids.<\/span><\/p>\n<p><span>However, only brief use or abruptly stopping opioid use might not solve the problem. Are there better ways to prevent issues related to opioid use and can we avoid using these drugs at all?<\/span><\/p>\n<h2>\u2018Negative Reinforcement\u2019 Could Increase OUD Risk<\/h2>\n<p><span>\u201cThere could be significant risk of acute discontinuation or overly aggressive tapering plans,\u201d Anna Legreid Dopp, PharmD, Senior Director of Clinical Guidelines and Quality Improvement at the American Society of Health-System Pharmacists (ASHP), told The Epoch Times.\u00a0<\/span><\/p>\n<p><span>She added that this could result in \u201cacute\u201d withdrawal symptoms in patients with physical dependence on opioids.<\/span><\/p>\n<p><span>A <\/span><a href=\"https:\/\/journals.lww.com\/pain\/Abstract\/2022\/01000\/Patient_outcomes_after_opioid_dose_reduction_among.10.aspx\"><span>study<\/span><\/a><span>\u00a0looked at Medicaid patients and found that abruptly discontinuing opioid use was associated with increased rates of death and suicide.\u00a0<\/span><\/p>\n<p><span>It also showed that the risk wasn\u2019t reduced by prescribing <\/span><a href=\"https:\/\/www.samhsa.gov\/medication-assisted-treatment\/medications-counseling-related-conditions\/buprenorphine\"><span>buprenorphine<\/span><\/a><span>, a drug used to reduce withdrawal symptoms.<\/span><\/p>\n<p><span>Recent research even <\/span><a href=\"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2791566\"><span>suggests<\/span><\/a> <span>that abruptly ceasing opioid use significantly increases the risk of developing OUD.<\/span><\/p>\n<p>Orman Trent Hall, DO, an addiction medicine specialist and assistant professor of Psychiatry and Behavioral Health at The Ohio State University Wexner Medical Center and College of Medicine, said we don\u2019t fully understand why sudden discontinuation of opioids increases the risk of developing OUD.<\/p>\n<p><span>\u201cOne possibility involves a form of learning called negative reinforcement,\u201d he explained.\u00a0<\/span><\/p>\n<p><span>He said that this happens when patients are quickly forced off opioids, and experience a \u201ccrisis\u201d of uncontrolled pain.\u00a0<\/span><\/p>\n<p><span>\u201cIf they begin using illegal opioids during this crisis,\u201d he continued. \u201cThey will learn to associate illegal opioids with relief.\u201d Later, when other life stressors come up, they may feel the only way to cope is by using illegal opioids.<\/span><\/p>\n<p><span>However, according to Tucker Woods, DO, chair of the emergency department and associate medical director of Lenox Health Greenwich Village, sudden discontinuation of opioids does not \u201ccause\u201d OUD.\u00a0\u00a0\u00a0<\/span><\/p>\n<p><span>Woods explained that sudden discontinuation of opioids can cause <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK526012\/\"><span>opioid withdrawal syndrome<\/span><\/a><span> after a patient has developed \u201cdependence,\u201d generally due to prolonged use.\u00a0<\/span><\/p>\n<p><span>\u201cBut [that] doesn\u2019t necessarily mean the patient has opioid use disorder,\u201d he said.<\/span><\/p>\n<p><span>Woods clarified the difference is that withdrawal symptoms are experienced when a dependent person doesn\u2019t have the drug. However, OUD is when a person compulsively seeks out the drug despite negative consequences.<\/span><\/p>\n<h2>A Better Way to Cut Opioid Use: Tapering Dosages<\/h2>\n<p><span>According to the Department of <\/span><a href=\"https:\/\/www.hhs.gov\/opioids\/treatment\/clinicians-guide-opioid-dosage-reduction\/#:~:text=The%20longer%20the%20duration%20of,for%20more%20than%20a%20year.\"><span>Health and Human Services<\/span><\/a><span> (HHS), opioid dosing should be \u201ctapered,\u201d rather than abruptly cut.<\/span><\/p>\n<p><span>It may be appropriate to begin reducing doses when there is an improvement in pain, when pain and function aren\u2019t \u201cmeaningfully\u201d improved, or when there may be signs of OUD.<\/span><\/p>\n<p><span>The agency cautions that healthcare providers should taper slowly enough to minimize withdrawal symptoms. Tapering plans should also be individualized for each patient\u2019s goals.<\/span><\/p>\n<p><span>\u201cThe longer the duration of previous opioid therapy, the longer the taper may take,\u201d advised HHS. \u201cCommon tapers involve dose reduction of five percent to 20 percent every four weeks.\u201d<\/span><\/p>\n<h2>Long and Short-Term Use Both Carry <a href=\"https:\/\/www.theepochtimes.com\/t-addiction\">Addiction<\/a> Risk<\/h2>\n<p><span>Recent <\/span><a href=\"https:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/S019606441501567X\"><span>research<\/span><\/a><span> indicates that for 29 percent of heroin users, their first opioid was prescribed in an emergency room (ED), while another <\/span><a href=\"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2738029\"><span>study<\/span><\/a><span> finds that even a five to nine-day prescription was linked to significantly increased odds of long-term use (90 days or more).\u00a0<\/span><\/p>\n<p><span>The <\/span><a href=\"https:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/S019606441501567X\"><span>study<\/span><\/a><span> authors concluded that ED opioid prescriptions could contribute to the development of addiction in some patients.\u00a0\u00a0\u00a0<\/span><\/p>\n<p><span>Dopp said chronic pain is a very serious patient concern, but the benefits of managing chronic pain with long-term opioid therapy \u201clacks evidence.\u201d\u00a0<\/span><\/p>\n<p><span>\u201cWhat we do know is that the longer a patient takes an opioid, the higher their risk is for side effects, misuse, and addiction,\u201d she said.<\/span><\/p>\n<p><span>Dopp explained that this also depends on the patient and how much opioid they may have been taking.<\/span><\/p>\n<h2>Treating and Preventing OUD<\/h2>\n<p><span>Woods emphasized that while treating addiction to opioids is not a \u201cone size fits all\u201d approach, <\/span><a href=\"https:\/\/www.who.int\/data\/gho\/indicator-metadata-registry\/imr-details\/2718\"><span>opioid agonist therapy<\/span><\/a><span> can be an effective treatment for individuals struggling with OUD.\u00a0\u00a0<\/span><\/p>\n<p><span>\u201cThere are only two FDA-approved drugs on the planet that have been shown in studies to reduce opioid overdose deaths,\u201d he said. \u201cAnd one is an opioid agonist [<\/span><a href=\"https:\/\/www.samhsa.gov\/medication-assisted-treatment\/medications-counseling-related-conditions\/methadone\"><span>methadone<\/span><\/a><span>] and the other medication is what is called a \u201cpartial agonist\u201d [buprenorphine].\u201d<\/span><\/p>\n<p><span>Woods noted that these drugs can be life-saving.\u00a0\u00a0<\/span><\/p>\n<p><span>\u201cBuprenorphine, for example, prevents cravings for opioids, prevents withdrawal from opioids, and also keeps the patient safe, will block other opioids if a patient has a return to use of other opioids.\u201d<\/span><\/p>\n<p><span>He added that there are alternatives\u2014for example, a monthly injectable medication called <\/span><a href=\"https:\/\/www.samhsa.gov\/medication-assisted-treatment\/medications-counseling-related-conditions\/naltrexone\"><span>naltrexone<\/span><\/a><span>, which is an opioid antagonist that actually blocks opioids and helps with cravings.<\/span><\/p>\n<h2>Alternatives to Opioid Therapy<\/h2>\n<p><span>Experts say that there are alternatives to opioid drugs for pain relief.<\/span><\/p>\n<p><span>\u00a0<\/span><span>Woods said that healthcare providers could stop providing these drugs and still offer effective pain relief.\u00a0<\/span><\/p>\n<p><span>\u200b\u201cThere are so many other options out there other than opioids for effective pain relief,\u201d he said.<\/span><\/p>\n<p><span>The <\/span><a href=\"https:\/\/www.asahq.org\/madeforthismoment\/pain-management\/non-opioid-treatment\/\"><span>American Society of Anesthesiologists<\/span><\/a><span> (ASA) lists safe and effective options that include aspirin, ibuprofen, and acetaminophen.<\/span><\/p>\n<p><span>They also note nondrug remedies such as massage, acupuncture, and \u2018high-tech\u2019 treatments using radio waves and electrical signals.<\/span><\/p>\n<p><span>\u201cPatients with chronic pain deserve effective treatment tailored to fit their individual needs,\u201d said Hall.<\/span><\/p>\n<p><span>He explained that alternative treatment may involve Physical or Occupational Therapy, non-opioid pain medications, adaptive equipment like braces, supports or sleeves, medical procedures, or surgeries.\u00a0<\/span><\/p>\n<p><span>\u201cSome of the most effective pain treatments people can do on their own,\u201d said Wood.\u00a0<\/span><\/p>\n<p><span>He recommended getting better sleep, managing stress, and exercising, which have been shown to improve pain and function.\u00a0\u00a0<\/span><\/p>\n<p><span>The most important point is that according to experts, in many cases, opioid drugs can be completely avoided to eliminate the risk of addiction to these powerful, and potentially dangerous drugs.<\/span><\/p>\n<div class=\"author_wrapper\">\n<div class=\"one_author_block round\">\n<div class=\"top_row\">\n\t\t\t\t\t<a href=\"https:\/\/www.theepochtimes.com\/author-george-citroner\"><img decoding=\"async\" src=\"https:\/\/www.conservativenewsdaily.net\/breaking-news\/wp-content\/uploads\/2022\/12\/george-citroner-.png\" alt=\"George Citroner\" \/><\/a><\/p>\n<p>Follow<\/p>\n<\/div>\n<p>George Citroner is a health reporter for The Epoch Times.<\/p>\n<\/p><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Opioid addiction and the illness and death associated with the misuse of these drugs is a growing health crisis. Last year, the Centers for Disease Control and Prevention (CDC) made<\/p>\n","protected":false},"author":1,"featured_media":1761929,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_mo_disable_npp":"","fifu_image_url":"https:\/\/cndimages.nyc3.digitaloceanspaces.com\/breaking-news\/wp-content\/uploads\/2021\/01\/IMG_2758-scaled-1.jpg","fifu_image_alt":"","footnotes":""},"categories":[547],"tags":[],"class_list":["post-1767511","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-the-bongino-report"],"fifu_image_url":"https:\/\/cndimages.nyc3.digitaloceanspaces.com\/breaking-news\/wp-content\/uploads\/2021\/01\/IMG_2758-scaled-1.jpg","_links":{"self":[{"href":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/wp-json\/wp\/v2\/posts\/1767511","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/wp-json\/wp\/v2\/comments?post=1767511"}],"version-history":[{"count":0,"href":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/wp-json\/wp\/v2\/posts\/1767511\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/wp-json\/wp\/v2\/media\/1761929"}],"wp:attachment":[{"href":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/wp-json\/wp\/v2\/media?parent=1767511"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/wp-json\/wp\/v2\/categories?post=1767511"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.conservativenewsdaily.net\/breaking-news\/wp-json\/wp\/v2\/tags?post=1767511"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}