Reduced opioid prescribing by oncologists: progress made, or ground lost?
Menée aux Etats-Unis à partir des données de la base Medicare, cette étude analyse l’évolution, sur la période 2013-2017, des prescriptions d’opioïdes des oncologues à leurs patients atteints d’un cancer
The U.S. is in the midst of an opioid epidemic that is killing 130 people each day.The origins of this epidemic are complex, arising in part from aggressive pharmaceutical marketing of opioids in the late 1990’s, campaigns to screen for pain as the “fifth vital sign,” and misleading narratives implying that opioids were safe and effective for non-cancer pain. These powerful yet largely unrecognized forces led to a quadrupling of opioid prescribing, which peaked in 2010-2012. Simultaneously, there was increasing recognition that cancer pain was undertreated, and alleviating it became a priority for oncologists and the emerging field of palliative care. 8 Influential organizations including the World Health Organization, the Agency for Healthcare Research and Quality,10 and the Institute of Medicine took notice, issuing guidelines emphasizing the importance of preserving opioid access for cancer patients, particularly at the end of life. As progress was made against cancer pain, an emerging epidemic went largely unnoticed until the mid-to-late 2000’s when deaths from prescription opioids surpassed those from heroin and cocaine combined.(…)
Journal of the National Cancer Institute , éditorial en libre accès, 2019