Expert Warns of Increase in Prescription Painkiller-related Deaths

Action is needed to tackle the increasing number of deaths in the U.S. and Canada from prescription painkillers known as opioids, according to experts in an article published online in the British Medical Journal.

Opioids contain compounds derived from the opium poppy. Although they have long been used to control the symptoms of cancer and acute medical conditions, they are increasingly being used to control chronic pain, for example, in patients suffering from osteoarthritis, according to Irfan Dhalla, MD and colleagues at the University of Toronto.

In the US, deaths involving opioid painkillers increased from 4,041 in 1999 to 14,459 in 2007 and are now more common than deaths from skin cancer, HIV and alcoholic liver disease, according to the researchers. They added that between 1.4 million and 1.9 million Germans are addicted to prescription drugs and that some authorities have suggested that the UK may face a similar epidemic to that of North America in 5 to 10 years.

“Deaths involving methadone and codeine roughly doubled in England and Wales between 2005 and 2009, while deaths involving heroin or morphine remained unchanged,” Dhalla and colleagues wrote in a press release.

In order to tackle the crisis in the US and Canada, the authors put forward several strategies. They suggest staff working for drug companies should not get commission for marketing prescription opioid drugs and that regulators should evaluate advertisements for them before they are disseminated. Another initiative would be to introduce real-time electronic databases to reduce the frequency with which opioids are obtained from multiple doctors or pharmacies.

Dhalla and colleagues also called for educational outreach programs for doctors to improve opioid prescribing, as well as more research to guide practice. They note that the evidence for the use of opioids to control chronic pain is very limited and the risks may outweigh the benefits.

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