Deaths from hydrocodone, oxycodone and other opioid pain medications have quadrupled since 1999 increasing from 4,030 deaths to 16,651 deaths in 2010. During the amount of opiate pain medications prescribed has quadrupled as well. Pharmaceutical companies and some pain management physicians claim that only a few patients are susceptible to death from overdose and believe that a screening tool can differentiate patients at low risk for overdose from high risk patients. A recent article in the Journal of the American Medical Association (JAMA) shows that opioid dependence is more common than believed and affects approximately one-third (1/3) of patients with chronic pain. Simply put, opioid pain relievers, and especially oxycodone and hydrocodone, are dangerous drugs.
Reliance on a screening tool is not safe, despite promotional pharmaceutical sponsored brochures that state that signs of opioid dependence in low risk patients can be ignored and the drugs can continue to be prescribed. Some pain management specialists claim that the underuse of these drugs causes people to use more. However, long term opioid results in tolerance which leads to higher doses being used. Despite the beliefs held by some practitioners and promoted by pharmaceutical companies that there is no maximum safe dose if opioids are increased gradually, the risk of death from overdose increases with higher doses.
Physicians have an ethical obligation to make an appropriate assessment of the risks of using these medications and in making an appropriate risk benefit analysis in patients that are prescribed opioid analgesics. When risks outweigh benefits, other treatments need to be considered. Wrongful death from opioid overdose has been a tragic end for many patients who trusted in their doctors and were prescribed unsafe dosages of oxycodone, hydrocodone and other opioid analgesics