Opioid Update

April 23, 2019

From the FDA on 4/18/2019:

 

"Opioids are a class of powerful prescription medicines that are used to manage pain when other treatments and medicines cannot be taken or are not able to provide enough pain relief. They have serious risks, including abuse, addiction, overdose, and death. Examples of common opioids include codeine, fentanyl, hydrocodone, hydromorphone, morphine, oxycodone, and oxymorphone.

Health care professionals should not abruptly discontinue opioids in a patient who is physically dependent. When you and your patient have agreed to taper the dose of opioid analgesic, consider a variety of factors, including the dose of the drug, the duration of treatment, the type of pain being treated, and the physical and psychological attributes of the patient. No standard opioid tapering schedule exists that is suitable for all patients. Create a patient-specific plan to gradually taper the dose of the opioid and ensure ongoing monitoring and support, as needed, to avoid serious withdrawal symptoms, worsening of the patient’s pain, or psychological distress (For tapering and additional recommendations, see Additional Information for Health Care Professionals).

Patients taking opioid pain medicines long-term should not suddenly stop taking your medicine without first discussing with your health care professional a plan for how to slowly decrease the dose of the opioid and continue to manage your pain. Even when the opioid dose is decreased gradually, you may experience symptoms of withdrawal (See Additional Information for Patients). Contact your health care professional if you experience increased pain, withdrawal symptoms, changes in your mood, or thoughts of suicide."

Our Commentary:

We offer Suboxone treatment for those who have become addicted to opioids as a result of physical pain. Suboxone relieves the symptoms of withdrawal.  Because it has naloxone, which blocks the effects of other opiates, it can prevent abuse, overdose and death from street acquired illicit opiates such as heroin and fentanyl as well as illicitly obtained prescription medications.  There are two strategies for the use of Suboxone: either stabilization and gradual tapering to stopping it, or continued treatment with Suboxone. We offer both.  Insurance pays for most Suboxone treatment and it is generally well tolerated.

We encourage anyone with an addiction to prescription pain medications who needs help with their addiction to contact us and discuss treatment with Suboxone.

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