How Can PCPs and Pain Docs Curb Opioid Abuse?

Charles E. Argoff, MD

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Posted: 08/22/2011

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Hi. I am Dr. Charles Argoff, Professor of Neurology at Albany Medical College and Director of the Comprehensive Pain Center at Albany Medical Center in Albany, New York. Today, I want to talk about how prescription drug abuse continues to be a significant and growing problem in this country, with all that we have learned about it, even in the last couple of years.

The Substance Abuse and Mental Health Services Administration (SAMHSA), a division of the federal government, has recently released a report regarding this matter. This report looks at treatment admissions for substance abuse. Of great interest to all of us who are involved in the care of patients, and specifically patients on opioids, is the significant increase in the number of treatment admissions for opioid prescription abuse. This is of great importance. The report highlighted the 5 most commonly abused substance groups, accounting for 96% of the treatment admissions: (1) alcohol, (2) opioids, (3) marijuana, (4) cocaine, and (5) methamphetamine or amphetamine. Those accounted for the 5 most commonly reported substances in the treatment admission group.

This report makes clear that we have not yet turned the corner in terms of trying to curb prescription drug abuse, specifically prescription opioid abuse. It really points to the need to work in a more collaborative way. Not infrequently, a primary care provider will refer a patient to me because of a concern about overuse of opioids. However, when I question that particular primary care provider, all too often, the prescriptions are being written by that same provider and no one else. We must collaborate earlier, before starting a patient on a path towards prescription opioid abuse. We are and should be in control of who we treat and what we do when we treat somebody. Certainly opioids may be an effective component of someone's treatment regimen, but as this report reminds us, the use of prescription opioids is still a huge issue with respect to substance abuse matters, and we really need to start to do what we can as prescribers to help curb this and actually start to see a decrease, if not at least stabilization.

I want to remind all of us that we are one medical community, and that it would be best to try to control this problem by working together before it consumes us. I'm Dr. Charles Argoff. Thank you for listening. I do understand that this is a very difficult topic, and it is difficult to change behaviors, but it's a topic that we really need to tackle together.