• Fewer opioid prescriptions concern some patients and health professionals

    By: Leah Jordan


    MEMPHIS, Tenn. - Headlines have been filled with warnings of doctors over-prescribing opioids for years now.

    Data from the Centers for Disease Control show there has been a change in opioid prescribing practices over the years – especially over the last few years.

    In 2016, the CDC issued a new guideline for primary care doctors prescribing opioids to patients

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    Since then, fewer prescriptions for opioids have been filled, but not everyone believes that’s a good thing. In fact, it completely depends on who you talk to. 

    Alisa Haushalter, Director of Shelby County Health Department, said creating guidelines on such a complex issue is no easy task. 

    “We all know having guidelines for providers and prescribing guidelines is critical to eliminating the epidemic,” Haushalter said. “However, there are some challenges to it as well."

    Wednesday, 300 medical professionals – including former White House drug czars, professors of addiction medicine, pain specialists, and patient representatives who have taken money from the pharmaceutical industry – wrote a letter to the CDC.

    The letter detailed their belief that the guidelines issued by the CDC may have had adverse effects.

    Some professionals claim some of their patients have turned to suicide or illegal drugs because it has become harder for them to get medication they need for their legitimate pain. 

    Haushalter said the CDC’s guidelines are just that: recommendations.

    But she said while nothing was mandated from the CDC’s 2016 guideline, there has certainly been a reaction to it that has changed how some practices operate.

    “There has been a reaction to the guidelines. Both by the provider industry, the broader healthcare systems, as well as the insurance industry,” Haushalter said. “Some organizations have put policies in place that are more mandates relative to the guidelines that could make it more difficult for a provider to prescribe.” 

    The letter from those 300 medical experts ended with a few requests.

    First, the medical professionals are calling on the CDC to follow through on their "commitment to evaluate the impact," by consulting directly with a wide range of patients and caregivers and by engaging epidemiologic experts to investigate reported suicides, increases in illicit opioid use and, to the extent possible, expressions of suicidal ideation following involuntary opioid taper or discontinuation.

    Finally, they urged the CDC to issue a “bold clarification” about the 2016 guideline.

    They want to see clarity on what it does and does not say, particularly on the subjects of opioid taper and discontinuation. 

    In Shelby County, there were 854 opioid related emergency department visits in 2018.

    There have been 650 opioid related deaths between 2013 and 2017.

    There were 607,512 opioid prescriptions for pain in 2017.

    Despite these numbers, Haushalter said Shelby County is not grappling with the opioid epidemic as intensely as other surrounding, more rural counties.

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