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Rx: Prescribe Less

I recently attended a webinar on the opioid crisis hosted by the AMA. Dr. Chad Brummett, Associate Professor, Department of Anesthesiology, Division of Pain Medicine at the University of Michigan Medical School shared his recent research findings on the crisis. The epidemic is transforming the way physicians approach pain management and prescribe medications. Here is what I learned:

. More than 25 million US adults are affected by daily pain. More than 2 million individuals in the US have an opioid “use disorder.”

. Most start with opioid analgesics like Norco, the brand name for hydrocodone, then once addicted, move on to heroin or synthetic opioids like Fentanyl, which is similar to morphine, only 30 times more powerful.

. Hydrocodone (Norco) is the number 1 prescribed med after surgery.

. More than 259 million opioid prescriptions are written each year in the US.

. While the US comprises only 4% of the world’s population, we as a nation consume 80% of all opioids.

. 115 Americans die every day from an opioid overdose.

. Of the patients new to opioids after surgery, 6% go on to become addicts / abusers

Who prescribes the most pain meds? At the top of the list are:

  1.Surgeons 2. Emergency room doctors 3. Dentists for dental procedures like wisdom teeth extractions 4. Physical Medicine and Rehabilitation doctors   5. Oncologists/Neurologists/Cardiologists

Dr. Brummett suggests that surgeons over-prescribe because they don’t want their patients complaining about pain. HOWEVER, according to his recent research, there is NO correlation between the number of pills prescribed and a patient’s satisfaction with their pain level. BOTTOM LINE for doctors: Prescribe less, patients take less.


Only 4% get their drugs from drug dealers. 55% get their drugs from a friend or relative without asking.  Since 72% of all prescribed opioids for outpatient general surgery go unused, they find pills lying around the house or in a bathroom cabinet.

Hope for the future? YES.

According to Dr. Brummett:

Doctors are learning to better communicate with their patients, preparing them for some pain after surgery or procedure.

Chronic pain patients are being educated on the benefits of meditation, mindfulness and gratitude practices and other forms of the healing arts.

Parents are learning to dispose of all unused pain meds; in fact, communities  across the country are now forming “opioid recovery” drives to dispose of all unused pills.

The NIH through their HEAL program is devoting resources to developing new treatments for addiction through immunotherapies and by reformulating existing medicines; they are also investing in new non-addictive pain treatments.

If you would like a copy of Dr. Brummett’s presentation, please view