Former Surgeon General Discusses Opioids, Prescription Limits & Addiction

By Kelly Burch 04/06/18

In a new interview, Dr. Vivek Murthy tackles the dangers of opioids, prescribing methods and non-opioid options for pain relief.

Former Surgeon General Vivek Murthy
Former Surgeon General Vivek Murthy Photo via YouTube

Former Surgeon General Vivek Murthy, who ordered the first-ever Surgeon General’s Report on Drugs, Alcohol and Health, spoke this week at Brigham and Women's Hospital in Boston, extolling the dangers of opioid use. 

Murthy, who was a physician at the hospital before taking the federal post, spoke alongside surgeon and best-selling author Atul Gawande, according to WBUR. Both of them discussed the opioid epidemic and the ways that it has changed the culture of medicine. 

Murthy emphasized that there are important preventative measures that doctors can take to help protect their patients from opioid addiction. These include avoiding prescribing opioids for acute pain and not prescribing opioids and benzodiazepines together. He said that if opioids must be used for acute pain, prescriptions should be limited to three days. 

"The point being that if you’re on opioids for more than three days," Murthy said, "there’s a much greater chance that you’ll continue to be on it at a year, compared to if you have a shorter prescription. So shorter prescriptions are better.“

He said that opioids shouldn’t be used at all for chronic pain, especially since new research shows that non-opioid options, including over-the-counter medications, provide pain relief that is just as effective in patients with chronic conditions. 

However, people need to work closely with their doctors to carefully taper off opioids if they have been on them long-term. 

"If somebody is on a massive dose of opioids and has been for five years and you cut them off immediately, you are actually putting them at substantial risk," Murthy said.

He said that this is particularly important to remember as Medicare finalizes a plan that will drastically reduce the type of opioid prescriptions that will be covered by the federal health insurance plan. 

Murthy and Gawande also discussed their surprise when research began emerging about just how addictive opioids are, including a study that found that 10% of patients who receive a one-week prescription for opioids will still be on the drugs a year later. 

"That is how addictive it is, and I had no idea," Gawande said. "I was fueling part of this crisis. We all were, along the way.”

Murthy said that despite advances in understanding the dangers of opioids, doctors and public health experts still don’t understand why some areas of the country are particularly hard-hit by the epidemic. 

“This has been a vexing problem to figure out," Murthy said.

Murthy also called for tougher punishments for pharmaceutical companies that have unsafe practices. 

"Many of the fines that we levy on pharmaceutical companies, we think they’re big, but they are a small fraction of even their marketing budgets," Murthy said. "So for many of them, these fines are just the cost of doing business."

Check out the in-depth discussion here.

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Kelly Burch writes about addiction and mental health issues, particularly as they affect families. Follow her on TwitterFacebook, and LinkedIn.