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According to a review presented in February at the American Academy of Pain Medicine's annual meeting, methadone accounted for 5% of opioid prescriptions in the U.S. between 1999 and 2009 but was 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...
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...
...over-the-counter painkillers like ibuprofen and naproxen, and other non-steroidal anti-inflammatory drugs (NSAIDs) like Celebrex (celecoxib). Guidelines written and published by the American Geriatrics Society warned against using these drugs chronically and at moderate-to-high doses in patients age 75 or older with persistent pain. Citing the many risks of long-term NSAID use, including fatal ulcers and gastrointestinal bleeding, increased risk of heart attack and stroke and dangerous interactions with other drugs commonly prescribed to the elderly, the American Geriatrics Society suggested that seniors try acetaminophen instead. If that doesn't ease pain, older patients...
Potential to Treat Psychological Pain One of the most intriguing new findings regarding opioid use came out of a study including 696 Navy and Marine troops who were injured in combat in Iraq between 2004 and 2006. Published in the New England Journal of Medicine in January, the study found that soldiers who were given morphine during resuscitation and treatment for physical trauma were half as likely to develop posttraumatic stress disorder (PTSD) as those who did not get the drug. (See the top 10 medical breakthroughs...
...that the brain's natural opioids are involved in feelings of nurture and bonding. Saxe found that the pediatric patients in the hospital who had the most anxiety about being away from their families were also the most likely to develop PTSD, but in those treated with opioids for pain, the risk was reduced. "The pathway was opioid dose reducing separation anxiety, and reduced separation anxiety reducing PTSD," says Saxe. (See pictures of an Army town coping with PTSD...