ACMT position statement on prescribing opioids: a missed opportunity

3 out of 5 stars Safety Issues Regarding Prescription Opioids. American College of Medical Toxicology J Med Toxicol 2016 Jan 5 [Epub ahead of print] No abstract available This “Position Statement” from the American College of Medical Toxicology (ACMT) covers 3 topics related to safety issues associated with use of prescription opioids. Unfortunately, some of the positions taken by the College are, to say the least, wishy-washy, and represent a missed opportunity to make some important points forcefully. The first topic addressed in this statement involves the use of medications that combine acetaminophen with an opioid such as hydrocodone (e.g., Vicodin.) This formulation never made any sense to me. Since the analgesic dose of acetaminophen is 1000 mg, and the acetaminophen-opioid preparations generally contain only 325 mg of acetaminophen, the patient would have to take at least 3 pills to get a therapeutic effect from the non-opioid component. In addition, as the position statement points out, patients who take more than the prescribed dose run the risk of acetaminophen-induced hepatotoxicity. The statement recommends: ” . . . when prescribing opioids, a risk-benefit analysis for both acetaminophen toxicity and opioid muse should direct the choice of a combination analgesic.” To my mind the combination product is all risk and no benefit. A stronger, more convincing, statement would recommend that combination products not be used at all. This was cert...
Source: The Poison Review - Category: Toxicology Authors: Tags: Medical american college of medical toxicology opiates opioids position statement prescribing Source Type: news