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The AAN and Opioid Narcotics. 2023

The American Academy of Neurology and Opioid Narcotics

The American Academy of Neurology is the prime neurologic organization in the world and impacts the practice of Neurology with its long history of excellent education, publications, conferences, and guidelines on neurologic practice through the years.

Opioid Narcotics have become a dangerous problem in the world due to multiple psychiatric and medical problems following widespread use the past years.  Multiple deaths and disability have been attributed to the widespread use of opioid narcotics in the US and the American Academy of Neurology along with other organizations such as the FDA have been helpful in restricting the use of narcotics. 

Although they are helpful for short term pain relief, such as when recovering from surgery, long-term use of these drugs cause depression, addiction and multiple medical problems.

Read my Mini Book on Migraine Here.

This is an article by Britt Talley Daniel MD, member of the American Academy of Neurology, migraine textbook author, podcaster, YouTube video producer, and blogger.

The International Classification of Headache Disorders has stated that opioid narcotics taken more than 10 days a month can lead to Medication Overuse Headache.  Medication Overuse Headache is found in 3 to 4% of the world population and is a disturbing chronic medical problem with severe headaches with migraine features of being one-sided and associated with nausea and vomiting, and sensitivity to light and sound.

In a headache practice 80-90% of new patients have Medication Overuse Headache due to the long term use of opioid narcotics.

Related questions

Problems with using narcotics medically.

Narcotic addiction for a patient is a life of constant pursuit of the drug that will work for their addictive problem. It is a life of multiple uses of medication, suffering, withdrawal. General pain may be worsened by this since the use of these drugs may activate the thalamus and turn on the brain causing more pain.  This is typical with migraine in which overtreatment can lead into medication overuse headache with chronic daily severe headaches with migraine features.

Also problems such as constipation, depression, insomnia, and anxiety can be aggravated by the use of these drugs.

 Illegal narcotic drugs.

There is a problem of importation of drugs into America from the southern borders.  This is all over the news and involves all of us either personally, or by connection with others.  Narcotic use commonly leads to addiction and accidental suicide death of many of our friends, daughters and sons in America along with great travail, sorrow, and misgiving.

So, what did the AAN say? Read It here.

ABSTRACT The Patient Safety Subcommittee requested a review of the science and policy issues regarding the rapidly emerging public health epidemic of prescription opioid-related morbidity and mortality in the United States.

Over 100,000 persons have died, directly or indirectly, from prescribed opioids in the United States since policies changed in the late 1990s. In the highest-risk group (age 35–54 years), these deaths have exceeded mortality from both firearms and motor vehicle accidents.

Whereas there is evidence for significant short-term pain relief, there is no substantial evidence for maintenance of pain relief or improved function over long periods of time without incurring serious risk of overdose, dependence, or addiction.

The objectives of the article are to review the following:

(1) the key initiating causes of the epidemic

(2) the evidence for safety and effectiveness of opioids for chronic pain

(3) federal and state policy responses

(4) recommendations for neurologists in practice to increase use of best practices/universal precautions most likely to improve effective and safe use of opioids and to reduce the likelihood of severe adverse and overdose events. Neurology® 2014;83:1277

Is there some hope?

Finally there is a light at the end of the tunnel in that there may be some decrease in this problem.  Large American companies added to the addiction problem to some degree by making them so available and many of them have have been sued for large amounts of money because of their roles in the use of narcotics.

Just the changing hydrocodone from a drug that could be called in over the telephone from a doctor’s office or written for three months so it’s restricted down like a class 4 narcotic limiting its use to a month and having the drug being written on a special prescription has really changed the use of that drug.

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All the best.

Britt Talley Daniel MD