Do not forget the worst opiate - Propoxyphene - that killed most people during 53 years - and caused the heroin epidemic

CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016

Data from: http://1.usa.gov/21M7Om7 and bit.ly/1SiOIAM  Our own CV

Prescription opioids can be used to treat moderate-to-severe pain and are often prescribed following surgery or injury, or for health conditions such as cancer. In recent years, there has been a dramatic increase in the acceptance and use of prescription opioids for the treatment of chronic, non-cancer pain, such as back pain or osteoarthritis, despite serious risks and the lack of evidence about their long-term effectiveness.

When the Prescription Becomes the Problem

• Providers wrote nearly a quarter of a billion opioid prescriptions in 2013—with wide variation across states. This is enough for every American adult to have their own bottle of pills.1
• Health care providers in the highest prescribing state, Alabama, wrote almost three times as many of these prescriptions per person as those in the lowest prescribing state, Hawaii.2
• Studies suggest that regional variation in use of prescription opioids cannot be explained by the underlying health status of the population.2
• The most common drugs involved in prescription opioid overdose deaths include:
  • Methadone
  • Oxycodone (such as OxyContin®)
  • Hydrocodone (such as Vicodin®)3

To reverse this epidemic, we need to improve the way we treat pain. We must prevent abuse, addiction, and overdose before they start.

Addiction and Overdose

Anyone who takes prescription opioids can become addicted to them. In fact, as many as one in four patients receiving long-term opioid therapy in a primary care setting struggles with opioid addiction.4,5,6 Once addicted, it can be hard to stop. In 2014, nearly two million Americans either abused or were dependent on prescription opioid pain relievers.

Taking too many prescription opioids can stop a person’s breathing—leading to death.

Prescription opioid overdose deaths also often involve benzodiazepines. Benzodiazepines are central nervous system depressants used to sedate, induce sleep, prevent seizures, and relieve anxiety. Examples include alprazolam (Xanax®), diazepam (Valium®), and lorazepam (Ativan®). Avoid taking benzodiazepines while taking prescription opioids whenever possible.

Side Effects

In addition to the serious risks of addiction, abuse, and overdose, the use of prescription opioid pain relievers can have a number of side effects, even when taken as directed:

• Tolerance—meaning you might need to take more of the medication for the same pain relief
• Physical dependence—meaning you have symptoms of withdrawal when the medication is stopped
• Increased sensitivity to pain
• Constipation

• Nausea, vomiting, and dry mouth
• Sleepiness and dizziness
• Confusion
• Depression
• Low levels of testosterone that can result in lower sex drive, energy, and strength
• Itching and sweating

When the Prescription Becomes the Problem

• Providers wrote nearly a quarter of a billion opioid prescriptions in 2013—with wide variation across states. This is enough for every American adult to have their own bottle of pills.1
• Health care providers in the highest prescribing state, Alabama, wrote almost three times as many of these prescriptions per person as those in the lowest prescribing state, Hawaii.2
• Studies suggest that regional variation in use of prescription opioids cannot be explained by the underlying health status of the population.2
• The most common drugs involved in prescription opioid overdose deaths include:
  • Methadone
  • Oxycodone (such as OxyContin®)
  • Hydrocodone (such as Vicodin®)3

To reverse this epidemic, we need to improve the way we treat pain. We must prevent abuse, addiction, and overdose before they start.