The Need for Better Opioid Management

By Michael Wong, JD (Founder & Executive Director, Physician-Patient Alliance for Health & Safety)

Opioids Can be Deadly

To say that opioids can kill is perhaps to overstate the obvious. According to the National Institute on Drug Abuse, overdose deaths involving any opioid have steadily risen from 2010 to the present:

“Opioid-involved overdose deaths rose from 21,088 in 2010 to 47,600 in 2017 and remained steady in 2018 with 46,802 deaths. This was followed by a significant increase through 2020 to 68,630 overdose deaths.”  

Unfortunately, just looking at overdose deaths only tells a part of the issue. When prescription deaths are included, from 1999-2020, more than half a million people have died from overdoses involving any opioid, whether prescription or illicit opioids:

The difficulty the opioid use is that the use of opioids is a double-edged sword – on the one hand, opioids are a great pain reliever; and on the other, opioids can be addictive, as Justine Igwe, a nursing student in Nigeria at the University of Nigeria Enugu Campus, recently wrote for us. 

Better Opioid Management Starts with Education

Better opioid management starts with better awareness. In a letter to the Food and Drug Administration (FDA), a coalition of medical and patient safety organizations (including the Physician-Patient Alliance for Health & Safety) wrote to the FDA Commissioner:

We are writing to express our concern that consumers are generally unaware of the inherent dangers posed by prescription opioids. We believe that the Department of Health and Human Services (HHS) and the Food and Drug Administration (FDA) have an opportunity to ameliorate this problem by:

  • Requiring all opioid prescriptions to clearly display the following warning: Serious, life-threatening, or fatal respiratory depression has been reported with the use of opioids, even when used as recommended.

  • Ensuring that signs be prominently displayed in all emergency rooms, pharmacies and doctors’ offices that share the same information; and

  • Conducting an extensive review of all federal agency opioid safety educational materials to ensure that they are accurate, consistent, easy-to-read and include information on the breathing dangers of opioids.

Opioid management - letter to FDA

Better Opioid Management Means Monitoring All Patients In-Hospital

Better opioid management also means monitoring all patients receiving opioids in the hospital. In our position statement, “Patients Receiving Opioids Must Be Monitored With Continuous Electronic Monitoring,” the Physician-Patient Alliance for Health & Safety believes that all patients receiving opioids must be monitored using continuous electronic monitoring.

PPAHS – together with American Association for Respiratory Care American Association of Nurse Anesthesiology, American Society of Anesthesiologists, Anesthesia Patient Safety Foundation, Louise H. Batz Patient Safety Foundation, Patient Safety Movement Foundation, and Society for Technology in Anesthesia – urge Congress to pass the Inpatient Opioid Safety Act:

Opioid management - Inpatient Opioid Safety Act

The Inpatient Opioid Safety Act “would improve patient safety and reduce thousands of preventable injuries and deaths from opioid-induced respiratory depression. It will save lives. The Centers of Medicare and Medicaid Services (CMS) has long recognized the fatal consequences of opioidinduced respiratory depression and has concluded that ‘Most opioid-related adverse events are preventable,’ and that the sedating effects of opioids make it difficult at times to properly assess the patient’s level of sedation. It can be incorrectly assumed that patients are asleep when they are actually exhibiting progressive symptoms of respiratory compromise: somnolence, decreased respiratory rate, and decrease in oxygen levels. These symptoms, if unrecognized, can progress to respiratory depression and even death.”

Better opioid management can save lives!

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