The US District of Columbia Department of Health, HealthHIV.com and DCEngage.com have invited, funded, and published the following 1.5-hour course in Continuing Medical Education:
https://reduceharmdc.org/training/cdc-clinical-practice-guidelines-for-prescribing-opioids/
The course is accredited by the Postgraduate Institute for Medicine. It is intended for patients, clinical professionals who treat chronic pain patients, and supporting practitioners. Patients need not apply for CME credit if you take the course.
Highlights of this deeply referenced course are as follows:
- Incidence of treatment-related substance use disorder or overdose is less than one patient per thousand patients who are treated with prescription opioid analgesics in the context of an ongoing patient-doctor relationship.
- In rare cases where a drug overdose, suicide attempt, or successful suicide occurs in patients who have been treated with prescription opioids, factors in mental health history are from six to twenty-four times more significant as predictors of short-term risk, compared to prescription of opioid pain relievers as such.
- Contradicting assertions of the US Centers for Disease Control and the Veterans Administration, 40 years of data published by both Agencies demonstrates beyond any reasonable doubt that there is no significant relationship between rates of opioid prescribing and either accidental drug overdose deaths or hospital admissions for overdose treatment.
- Over-prescribing of opioid pain relievers to chronic pain patients is not now and has not been for 40 years, a dominating cause of accidental drug overdose. That distinction belongs to illegal drugs circulating in street markets — presently illegal fentanyl and stimulants like cocaine or methamphetamine, often compounded by alcohol. Such markets are almost totally unknown to patients with regular health insurance who are treated adequately for pain by a doctor.
The significance of these findings cannot be over-emphasized. There is evidence from multiple published sources that US CDC and Veterans Administration guidelines on prescription of opioids published in 2022-2023 contained fatal research errors. A strong case can be made that these errors were known to the Agency authors and reviewers of both documents before publication.
Filed under: General Problems
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