In a note published yesterday, the Haute Autorité de Santé (HAS) underlines the need to prevent the overconsumption of opioids. Abroad, particularly in the United States, a health crisis induced by the overconsumption of these drugs is underway. Thus, the HAS exposes the precise and supervised therapeutic strategies intended for the use of these drugs. Explanations.
What medical use for opioids?
Avoid any risk of misuse of opioids and addiction in patients. This is the objective set by the HAS. Indeed, in 2015, nearly 10 million French people were prescribed opioid analgesics. A figure that has been on the rise in recent years. Moreover, in the United States or the United Kingdom, a health crisis marked by the large number of deaths attributable to the overconsumption of opioids is underway.
The term “opioids” includes compounds extracted from poppy seed, semi-synthetic and synthetic, which have the same properties. Opioids include heroin, morphine, codeine, fentanyl, methadone, tramadol, and other similar substances. Due to their pharmacological effects, they can cause breathing difficulties. Overdose can lead to death.
In the medical setting, some of them can be included in pain management. They then have the role ofanalgesic, that is, they are used to reduce or eliminate pain, but do not treat the cause. Among the derivatives of opioids, some are part of level II analgesics. They are used to treat moderate to severe pain. Others may be prescribed for severe pain. Since they act directly on the brain, they can cause a phenomenon habituation and addiction. That is why their use is strictly supervised.
Strengthen recommendations to address opioid overuse
In France, the challenge is to make the use of opioids more secure without restricting access for patients who need them. This is a major issue in the context of the aging of the population and the increase in chronic diseases which promote the multiplication of painful symptoms. Faced with the increase in the consumption of opioid analgesics, the HAS insists on two points:
- Maintaining the mobilization of health professionals around a just prescription;
- The non-trivialization the use of these drugs. Indeed, this precaution is necessary regardless of the potency of the opioid. The risks of developing a use disorder or overdose are common to all opioids. The important thing therefore lies in the duration of the prescription and the quantity. Regardless of the type of opioid medication, too much of a prescribed amount can quickly become problematic.
HAS has also produced detailed recommendations for each situation where opioids can be prescribed: treatment of chronic non-cancer pain, acute pain, pain related to cancer or in pregnant woman and breastfeeding.
Personalization of prescriptions
In its report, the HAS specifies the use of opioids according to each situation:
- In the context of treatment of chronic non-cancer pain, she specifies that opioid analgesics should only be considered as a last resort. For example, they cannot be prescribed for chronic pelvic pain or migraines;
- When the prescription of opioids is necessary, she recommends initiating the gradual treatment. Daily reassessments are scheduled at the start of treatment to adjust the dosage and monitor the appearance of adverse effects;
- Beyond 6 months of continuous treatment, the HAS advises to gradually reduce the treatment, or even stop it. This allows the justification of the treatment to be checked and the dose to be reduced if necessary.
With the update of the recommendations for the prescription of opioid analgesics, the HAS aims to contain the increase in their consumption so as not to tip over into a health crisis.
Alexia F., Doctor in Neurosciences
Sources
– Proper use of painkillers. ameli.fr. Accessed March 25, 2022.
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