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BackPage Online, August 2016

doi: 10.1097/01.BACK.0000490039.32477.dd
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Opioid Use Down, Overdose Deaths Way Up

An article in the July edition of the BackLetter pointed out that the number of prescriptions for opioids in the U.S. is finally falling—and has fallen by about 3% since 2012. However, this is a drop in the bucket relative to the total number of opioid prescriptions, which tallied 252 million in 2012.

Overdose death rates continue to rise despite the modest reduction in opioid prescription. A recent article in the Cleveland Plain Dealer noted that the number of opioid prescriptions in Ohio has fallen 11.5% since 2012. Despite this encouraging statistic, overdose death rates have risen more than 59% over the same period.

So American physicians, healthcare systems, and governments need to do more than modestly reduce the number of opioid prescriptions.

Here is the wide-ranging article:

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Physician Burnout an Obstacle to Resolving Opioid Crisis—and the Back Pain Crisis

American physicians are reporting burnout and depression at record levels. Many have lost control over their jobs and even their private lives. They face never-ending demands from merciless healthcare systems. As Stephen A. Adelman, MD, pointed out in the Harvard Health Blog, they answer to a growing cadre of masters: faceless managed-care bureaucrats; managers; IT consultants; quality measurement gurus; and... patients.

Given these pressures American physicians may simply lack the requisite time and mental space to help patients address low back pain without the aid of strong narcotics. That is certainly a contributing factor to the sky-high opioid prescription rate for low back pain. Healthcare systems and society may need to improve the lives of doctors before they can improve the lives of back pain sufferers seeking medical advice.

Here is the article:

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Beware the “21st Century Cures Act”

New regulations nearing passage in the U.S. Congress may lead to the widespread approval and dissemination of unproven medical devices. An informative article by Trudy Lieberman at points out that the “21st Century Cures Act” intends to speed innovative medical interventions into the clinical marketplace by reducing the evidence burden necessary for FDA approval. However, current evidence standards are themselves inadequate. If they are weakened, neither healthcare providers nor patients will have any basis for determining the safety and effectiveness of medical devices.

Here is the article:

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