Deaths due to
opioid analgesics have increased substantially in the United States.
Among the changes, the FDA is requiring boxed warnings--the agency's strongest warning--and patient-focused Medication Guides for prescription
opioid analgesics, opioid-containing cough products, and benzodiazepines (nearly 400 products in total), with information about the serious risks associated with using these medications at the same time.
Additionally, the number of patients who were prescribed both an
opioid analgesic and benzodiazepine rose by 41% between 2002 and 2014, which translates to an increase of more than 2.
In contrast, two recent case-control studies have showed significantly increased risks for early pregnancy
opioid analgesic use and specific defects.
In exploratory analysis, gastroschisis was also significantly associated with
opioid analgesic exposure in early pregnancy (OR, 1.
The members were specifically tasked with addressing a number of questions, such as whether the current REMS ensures safe use of ER/ LA
opioid analgesics without unduly limiting patient access to medications or burdening the health care system, whether the scope of the current FDA blueprint for prescriber education for ER/ LA
opioid analgesics should be broadened, and whether immediate-release formulations should be included in the REMS, among other questions.
Therapeutic treatment of pain for the laboring patient include
opioid analgesics, epidural block, and alternative therapies that do not include medication efforts to relieve pain.
Patients experiencing moderate to severe pain for a range of underlying physiological reasons are virtually exclusively treated with
opioid analgesics.
Of these,
opioid analgesic and cough medicines accounted for the most deaths (20).
From 1990 to 1996, medical use of four
opioid analgesics increased substantially: morphine (59%), fentanyl (1168%), oxycodone (23%), and hydromorphine (19%), while medical use of one
opioid analgesic, meperidine, decreased (35%) (Joranson et al.
7 On each visit, assess whether the
opioid analgesic is improving the patient's function and quality of life and whether or not it should be continued.
To test for differences between all beneficiaries in the study population and those with claims for any
opioid analgesic or for controlled-release oxycodone, we used t tests for continuous variables and [chi square] tests or Fisher exact tests for categorical variables.