Each day, 46 people die in America after overdosing on prescription painkillers. In 2012 alone, the CDC says 259 million prescriptions were written for painkillers, enough to supply every American adult with a bottle of pills.
"Opioids are essential medicines for end-of-life care or when used short term for acute pain, but this vast overprescribing of opioids is mainly for conditions where use of opioids are probably not safe or effective, like low back pain with a normal spine, fibromyalgia, chronic headache."
"If prescription drug abuse is an epidemic, then I think chronic pain may be a pandemic, because the Institute of Medicine tells us that affects over 100 million people in the United States. "
http://www.pbs.org/newshour/bb/u-s-regulate-powerful-painkillers/
The Singapore guidelines, which were published in the latest edition of local medical journal Annals Academy of Medicine, cover 10 types of long-term pain ranging from headaches to back, neck and chronic post-surgery pain.
They advise doctors to set an "opioid agreement" with the patient by signing a form detailing terms of the treatment. Patients who do not agree will not be given the drugs. For those who agree, a trial period of one or two months is recommended before the prescription is extended. They should then be monitored regularly - for example by taking urine and blood tests - to make sure they are taking the right doses.
Doctors are also advised to be on the alert for telltale signs of addiction, such as forging of prescriptions, asking for higher dosages and "doctor-shopping" - going to many clinics to obtain more painkillers but without the knowledge of the original physician. Such patients are to be gradually taken off the drugs to prevent withdrawal symptoms. The regimen should also be stopped if the patient's pain fails to subside.
The guidelines also instruct doctors to be especially cautious when it comes to patients with a history of alcohol or drug abuse, as they may become addicted to the medication more easily.
