Prescribing Opioids: Universal Education on Opioid Use, Storage, and Disposal
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OPIOID USE IN AN OPIOID EPIDEMIC (S DALAL, SECTION EDITOR)
Prescribing Opioids: Universal Education on Opioid Use, Storage, and Disposal Maxine de la Cruz 1 Accepted: 27 October 2020 / Published online: 26 November 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review This article highlights the challenges in opioid prescribing and provides guidance on patient education for opioid safety, storage, and disposal as well as recommendations for cautious prescribing for a patient with cancer. Recent Findings Amid the opioid crises, multiple groups have reported that there is a gap in knowledge among patients and prescriber on proper opioid use, storage, and disposal that contributes to unsafe opioid practices. Summary Opioids are important in the treatment of pain in majority of patients with advanced cancer. Clinicians managing cancer-related pain have faced significant challenges in safely prescribing opioids in the time of an opioid epidemic and mounting evidence of non-medical opioid use in this patient population. Keywords Opioid disposal . Opioid use . Opioid prescribing . Opioid storage . Cancer pain . Opioid misuse . Opioid abuse . Opioids
Introduction
Safe Opioid Prescribing
The USA has an opioid epidemic problem. According to the Centers for Disease Control and Prevention (CDC), nearly 70% of the 67,367 deaths due to drug overdose in 2018 involved an opioid, and on average there were 130 daily deaths from accidental overdose of opioids, either alone or in combination with other substances [1]. As a result of these staggering numbers, policy makers and professional organizations have set out guidelines and mitigation practices to try to address this growing crisis. This article will outline risk factors for opioid misuse or nonmedical use as well as enumerate a workable framework by which practices and providers can adapt as they care for patients on opioids.
The human pain experience is often a complex multi-faceted symptom that is frequently reported in patients with cancer with a prevalence of 30–50% in those receiving cancerdirected treatments and more than 70% in patients with advanced disease [2, 3]. Opioids are an integral part of treatment of pain in cancer patients [4, 5]. Data has emerged that at least one in five cancer patients being treated with opioids may be at risk for opioid misuse or non-medical opioid use [6]. One study out of the Veterans Affairs looked at patients prescribed opioids 2004–2005, which showed higher risk of opioid overdose and opioid related deaths in patients who received higher daily dose of opioids [7]. In recent years, there have been a steady rise of opioid related deaths that often result from unsafe opioid use and misuse prompting a call for proper guidance on opioid prescribing, stricter policies on dispensing and more robust educational programs for patients, families and the general public [8–11]. Clinicians prescribing opioids need to incorporate universal screening practices when caring for patients on opioids. Thi
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