Chronic Noncancer Pain Management and Opioid Overdose: Time to Change Prescribing Practices

At this writing, opioids are the most commonly pre-scribed class of medication in the United States (1). Prescription of some opioids, such as methadone, has in-creased more than 800 % in the past 10 years (2). This increase in opioid prescribing has caused an increase in overdoses and deaths. Opioid overdose is among the most common causes of death nationwide (3). The increase in deaths due to prescription opioids is a major public health priority and not just a concern for individual physicians and their patients. It is easy to blame the growing epidemic of opioid overdose and death on manipulative patients who misrep-resent pain symptoms to obtain drugs to abuse or sell. A recent report (4) on overdose deaths in West Virginia found that 51 % occurred in persons who had never actu-ally been prescribed an opioid (that is, prescription diver