Narcotics

or the official name ... Opioids … one of the most challenging aspects of clinical medicine,
and at the DOC!

What are narcotics?

How the world has changed in regards to narcotic use?

• Until the early 1990s, narcotics were used primarily for cancer pain or acute pain.
• As chronic (on-going) non–cancer pain increased, doctors began to use narcotics for this type of pain.

• This change was encouraged partly by "Pharma" (the companies that make the drugs), and also by some studies that seemed to show little risk of addiction or diversion.
• So prescribing narcotics for chronic non-cancer pain grew enormously. Some patients were prescribed these medications for years!
• But, there are many risks, and not all of those risks were fully understood when narcotics began to be used for non-cancer pain.
• As we now know, the risk for addiction or diversion is actually high!
• All narcotics, such as oxycodone, morphine, Vicodin, MS contin, and even tramadol are the issue.

• Pain is complicated with no test or way to prove someone is or is not in pain. And different people perceive pain differently. 
• After years of little discussion about these risks, now we are hearing a lot about the rate of death from narcotics.  
• Other countries have not used narcotics like we have in the US and don’t have the issues we now have.

Deaths?  Really?
YES!!!

• Narcotics can cause breathing to slow down, and even stop. 
• Narcotics can cause chest pains and heart failure.
• People who use needles to inject narcotics are at risk of HIV, Hepatitis and other infections.
• Using a dose higher than the body is used to (for example a relapse after not using them for a while) is especially dangerous.
• In North Carolina, deaths from narcotics increased 73% from 2005 to 2015.
• In Durham County, narcotic-related deaths nearly tripled during that same time period.   
• Since opiates are becoming harder to get, some people switch to heroin (street opiate), since it is often cheaper and easier to get.
• From 2005-2015, heroin  deaths in North Carolina increased 884%.

Stay tuned:

Well, how do we keep patients safe?