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Some of the overdose cases involved known drug misuse or suicide attempts, while others were due to patient error, but the study could not identify exactly what went wrong in all of the cases. Was it the high-prescribed dose alone, or were there other risk factors like illness, escalation of pain or undiagnosed addiction? While Von Korff and Volkow agree that prescription dose is a major contributor to overdose risk, they say better studies are needed to determine the precise causes and consequences. "One would hope that for a treatment regimen that millions of people are using...

Author: /time Magazine | Title: Are Doctors Too Reluctant to Prescribe Opioids? | 2/24/2010 | See Source »

...involved in 30% of opioid overdose deaths, as reported in malpractice cases, medical literature and federal and state databases. Some of these deaths occurred in heroin users being treated with methadone for addiction, but the overwhelming number of cases were in people who were prescribed the drug for chronic pain. (See the most common hospital mishaps...

Author: /time Magazine | Title: Are Doctors Too Reluctant to Prescribe Opioids? | 2/24/2010 | See Source »

Much of the blame may fall on the Food and Drug Administration (FDA) and physician ignorance. Until 2006, FDA guidelines, which have since been revised, suggested starting pain patients on 80 mg of methadone a day - a dose that could kill people who haven't developed tolerance to this class of medications. The current recommendations call for 30 mg to start...

Author: /time Magazine | Title: Are Doctors Too Reluctant to Prescribe Opioids? | 2/24/2010 | See Source »

...happen to think that methadone is an extraordinarily valuable drug," says longtime opioid researcher Gavril Pasternak, head of molecular pharmacology at Memorial Sloan-Kettering Cancer Center in New York City. "It works in many patients who don't respond to other agents, but it is more dangerous in the sense that it's more difficult to prescribe appropriately. We have to do better in terms of educating physicians...

Author: /time Magazine | Title: Are Doctors Too Reluctant to Prescribe Opioids? | 2/24/2010 | See Source »

...doubling of the risk of broken bones in the elderly. "One-third of these were hip and pelvic fractures," Von Korff says. "These can really be debilitating." The authors speculate that the patients may have been prone to falls caused by dizziness or sedation, side effects of drug treatment that tend to occur early in a new drug regimen or when dosage changes...

Author: /time Magazine | Title: Are Doctors Too Reluctant to Prescribe Opioids? | 2/24/2010 | See Source »

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