New Limits for Opioid Prescribing?

A Call for Doctors to Dial Back the Use of Painkillers

Health care providers must radically limit their practice of prescribing of opioid painkilling medications if the nation is to make headway in ending the epidemic of drug overdose deaths.

That's the take-home message delivered in an op-ed published in Monday's Wall Street Journal by Richard S. Larson, MD, PhD, executive vice chancellor of the UNM Health Sciences Center. The essay, which reflects Larson's personal viewpoint, was published alongside one arguing that limiting opioid prescriptions would leave too many people in pain.

The Centers for Disease Control and Prevention estimates that more than 40 percent of opioid-related deaths involve a prescription opioid, Larson writes. And while pharmaceutical manufacturers bear some responsibility for the problem, overprescribing opioid drugs by physicians, dentists and other providers plays a role as well, he says.

He argues for stronger government oversight in two areas.

First, outpatient prescriptions for acute pain (as opposed to chronic pain) should be limited to three days - and prohibited for adolescents, Larson suggests. Those requirements could be modified after consultation with a pain specialist for exceptional circumstances

Second, health care systems should be required to create opioid stewardship programs to monitor the prescribing habits of providers, with the results reported to state medical and dental licensing boards. Similar measures have proven effective with regard to antibiotic prescriptions, he notes.

Daniel Duhigg, DO, program medical director for behavioral health at Presbyterian Healthcare Services and clinical associate professor in the UNM School of Medicine, contributed to the essay.