According to experts on bmj.com, the increasing number of deaths in the U.S. and Canada from prescription painkillers (opioids) requires urgent action.

Opioids are prescription painkillers that contain compounds extracted from the opium poppy and have long been used to control cancer symptoms and acute medical conditions. Using opioids for controlling chronic pain, such as in osteoarthritis patient’s, is increasing according to Dr IrfanDhalla and his colleagues at the University of Toronto.

Dr Dhalla and his team report that the death rate involving opioid painkillers in the U.S. rose from 4,041 in 1999 to 14,459 in 2007 and is now more common than deaths from skin cancer, HIV and alcoholic liver disease. With between 1.4 million and 1.9 million Germans also being addicted to prescription drugs some authorities are concerned that the UK may face a similar epidemic to that of North America in five to ten years time.

Dr. Des Spence commented earlier on bmj.com that using strong opioids for chronic non-cancer pain in the UK is a “disaster in the making”. Dr. Dhalla supports the comment saying that deaths involving methadone and codeine roughly doubled in England and Wales between 2005 and 2009, while deaths involving heroin or morphine remained unchanged.

The researchers recommend several strategies to overcome the crisis in the U.S. and Canada. They suggest to stop commission payments paid to the staff of drug companies for marketing prescription opioid drugs, and that regulators should examine adverts for these drugs before they are publicized. Another strategy would be to introduce real-time electronic databases to reduce the frequency with which opioids are obtained from multiple doctors or pharmacies.

Dhalla and his fellow researchers also suggest to implement educational outreach programs for doctors to improve opioid prescribing, as well as more research to guide practice. They highlight that the evidence for using opioids to control chronic pain is very limited with risks possibly outweighing the benefits.

The authors conclude:

“maintaining access to opioids for appropriately selected patients while striving for major reductions in overdose deaths must be a major priority for physicians and policymakers.”

Written by Petra Rattue