Overprescribing opioids − unreasoned expectations and underestimated risks underpin epidemic

The majority of overdose deaths in the US involve pharmaceuticals, and three quarters of those pharmaceuticalrelated overdose deaths involve opioid analgesics. In January 2013, a US FDA advisory committee voted to tighten the rules governing the prescription of hydrocodone-containing medicines. While some believe such changes will dramatically cut down on the drugs’ misuse, others are concerned that they will make it more difficult for legitimate patients to receive the medication they need. New York City (NYC) has taken steps of its own to ensure safer prescribing of opioid analgesics, most recently publishing guidelines for the use of opioid analgesics in hospital emergency departments. Commentators believe that many physicians and patients have had unreasonable expectations of opioids and have underestimated their risk. In support of the NYC guidelines, they advise that these drugs be prescribed less readily, to fewer patients, at lower doses and for shorter periods.