Long-Term Opioid Use Could Depend on the Doctor Who First Prescribed It - The New York Times
▻https://www.nytimes.com/2017/02/15/health/long-term-opioid-use-doctors-prescriptions.html
Over all, researchers estimated that out of every 48 patients who were sent home with a prescription, one would end up using opioids long-term, which researchers defined as at least 180 days of medication over a year. Chronic opioid use, particularly in older people, can contribute to spiraling problems: constipation, confusion, falls and addiction.
But the risk of becoming that patient increased or decreased depending on the treating physician. Researchers found that doctors they identified as “high-intensity” prescribers sent one in four patients home with opioids. “Low-intensity” prescribers gave opioids to one in 14 patients. The patients who saw a high-intensity prescriber were 30 percent more likely to become long-term users, researchers said.
The study did not seek to lay blame for the well-documented rise in opioid use by Medicare patients at the feet of emergency room doctors. Indeed, after patients receive an opioid prescription from the emergency room, they usually have subsequent prescriptions written by doctors outside the hospital, especially primary care physicians. The study’s authors alluded to “clinical inertia” — the belief among follow-up physicians that if the emergency room doctor’s prescription did the trick, they might as well refill it.
But he also noted that there is a “structural disincentive” to offer alternatives to medication, such as acupuncture, massage therapy, physical therapy, because of poor insurance reimbursement.
Les big pharma ne dirigent le monde qu’avec la comlicité des médecins. L’inconscience des effets sociaux et de long terme des prescriptions est véritablement une question à poser devant toute la société, pas seulement devant les corps médicaux spécialisés... et la prévention, le sport, les techniques alternatives prennent alors toute leur place dans l’arsenal médical.