WPCNR CAPITOL HILL. FROM THE OFFICE OF NY SENATOR KIRSTEN GILLIBRAND. FEBRUARY 5, 2016:
U.S. Senators Kirsten Gillibrand (D-NY) and Shelley Moore Capito (R-WV) today urged the Centers for Disease Control and Prevention (CDC) to issue guidelines for doctors prescribing opioids for acute pain.
Currently, the CDC is only focused on guidelines for opioids prescribed to treat chronic pain. However, many individuals become addicted to opioids after taking prescriptions for acute pain. Acute pain includes pain following a broken bone, wisdom tooth extraction, or other surgeries, whereas chronic pain is long-term pain often from chronic conditions.
“For many people, difficulties with opioid addiction began after receiving a prescription for acute pain. Many people with acute pain haven’t had previous opioid exposure and may be at heightened risk for addiction, and opioids prescribed for acute pain frequently end up being inappropriately given or sold to other individuals for recreational use. By updating the prescribing guidelines for acute pain, we can minimize the initial exposure to opioid medications and further limit the number of opioid prescriptions,” the Senators said.
Senators Gillibrand and Capito have continued to push for reforms to combat opioid abuse. They are cosponsors of numerous bills that would address opioid use, including legislation that would provide resources for states and local communities to address addiction with prevention and treatment programs.
The full text of the letter is below:
The Honorable Debra Houry
Director, National Center for Injury Prevention and Control
Centers for Disease Control and Prevention
1600 Clifton Road
Atlanta, GA 30329
Dear Dr. Houry,
We write to encourage the Centers for Disease Control and Prevention (CDC) to issue prescribing guidelines for opioids in the case of managing acute pain, including pain following an injury, such as a broken bone, or a medical procedure, such as a wisdom tooth extraction, and to include adolescents and children in these guidelines. We also request that CDC investigate the effects of opioid prescriptions for acute versus chronic pain on opioid misuse, abuse, and addiction.
We applaud the efforts of the CDC in updating opioid prescribing guidelines for chronic pain. It is widely known that at least part of the opioid epidemic can be attributed to an overabundance of opioid prescriptions written by providers, and substantial research exists linking the use of opioids for chronic pain and opioid addiction. As there are now more than 2 million Americans suffering from an opioid use disorder, it is critical for prescribers to thoughtfully and responsibly prescribe these powerful narcotics.
However, not all individuals with opioid use disorders have chronic pain. For many, their difficulties with opioid addiction began after receiving an opioid prescription for acute pain. For example, a study published in the Journal of the American Dental Association found that 64% of surveyed dentists preferred prescribing hydrocodone with acetaminophen after a third molar extraction—a procedure commonly completed on teenagers and young adults—for an average of 20 pills per prescription. These researchers recognized that a 20-pill prescription may be more than necessary, and that writing prescriptions for larger numbers of pills, when only a few pills will suffice, may cause patients to misuse the remaining pills. One example of misuse is diverting or giving away pills to another person. Indeed, countless studies have shown that at least some teenagers divert these excess pills to their friends. Moreover, the National Institute on Drug Abuse (NIDA) reports that adolescents who abuse opioids are more likely to receive these medications from a friend or family member.
Another recent study utilizing data from NIDA found that teenagers who received an opioid prescription by Grade 12 were 33% more likely to abuse opioids after high school. Perhaps most striking, these researchers found the risk for opioid abuse was even higher among teenagers who reported little to no previous use of illicit substances. For these teenagers, this opioid prescription may be their first introduction to addictive substances. That it is prescribed by a physician may create the notion that the substance is “safe,” leading to misuse of the substance.
Overprescribing of opioids for acute pain is therefore potentially problematic in two ways. First, individuals with acute pain, particularly those who have not had previous exposure to any illicit substances, may be at heightened risk to abuse or become addicted to these substances in the future. This trend may be particularly relevant for younger patients. Second, as the research has shown, these prescriptions contribute to the available supply of opioids and are frequently and inappropriately diverted to others. More research on opioid prescriptions for acute pain and its relation to illicit opioid use would further illuminate these potential paths to addiction.
Prevention of overprescribing or inappropriate prescribing of opioids is a key component to combating the opioid epidemic. By updating the prescribing guidelines for acute pain, including those prescribed to adolescents and children, we can minimize the initial exposure to opioid medications and further limit the number of opioid prescriptions, which can have positive downstream effects on combatting opioid abuse. Furthermore, investigating the link between opioid prescriptions for acute pain and opioid abuse would better inform efforts to reduce opioid use disorders.
Thank you in advance for your attention and cooperation with our request. We look forward to hearing from you on this matter.
Sincerely,
Kirsten Gillibrand
United States Senator
Shelley Moore Capito
United States Senator
WPCNR LETTER TICKER. JANUARY 28, 2016:
The following correspondence with the Mayor of White Plains has been shared with WPCNR by the Gedney Association:
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Hillary Clinton leaving this morning’s fundraiser in White Plains. The news media was denied admittance to the event, and reporters and photographers were kept far back from Mrs. Clinton’s arrival/departure location at 1133 Westchester Avenue. Details to follow later today. Photo exclusively
for WPCNR by Peter Katz.
WPCNR CAMPAIGN 2016. Special to WPCNR by Peter Katz. January 28, 2016:
Hillary Clinton emphasized the differences between herself and her chief rival for the Democrat Party’s Presidential nomination, Senator Bernie Sanders, during a fund raising event in White Plains on Thursday morning.
She said that his plan for free college for anyone who wants it is not realistic, and he doesn’t explain how it will be paid for. Mrs. Clinton also criticized his plan to scrap Obamacare and move everyone onto Medicare, suggesting that Sanders put forward the idea without thinking it through and understanding the financial implications of such a move.
She noted that she was very familiar with the complications involved in attempting to restructure healthcare in the U.S., having led an effort for healthcare reform while she was First Lady. Mrs. Clinton thanked those in attendance for their support, both monetary and philosophical.
She explained that her recent campaigning in Iowa has given her the opportunity for an even deeper understanding of the needs of the American people, especially the middle class which has lost ground while the extremely wealthy continue to expand their holdings.
The former First Lady, Senator, and Secretary of State addressed an enthusiastic gathering of about 500 who had paid from $250 to $2,700 per ticket for breakfast and the chance to hear her speak, and perhaps shake her hand and pose with her for a photo.
The event was staged by the group Westchester for Hillary in an office building owned by the development company RPW Group at 1133 Westchester Avenue. The building’s atrium was transformed into a venue complete with dining tables and a stage.
Reporters and photographers were not allowed inside to cover Mrs. Clinton’s speech. However, one of the attendees initiated a live video feed of her speech using a cell phone application, allowing the few journalists who were aware of the feed to monitor what she was telling the gathering. In addition, an elected official who was attending the event subsequently shared with the news media a photo he had taken inside.
The event was scheduled to take place from 8:30 am to 10:30 am. Mrs. Clinton’s motorcade of three vehicles arrived at about 8:50 am. Instead of being directed to the circular driveway in front of the main entrance, Mrs. Clinton was taken to a rear entrance, out of sight of the television cameras which were waiting in the front. She stayed longer than expected, not leaving until shortly before 11 am.
Congresswoman Nita Lowey introduced Mrs. Clinton. Among the other Democratic officeholders who attended were County Board of Legislators Chairman Mike Kaplowitz, Assemblyman David Buchwald, New Rochelle Mayor Noam Branson, White Plains Mayor Thomas Roach, and State Senator Andrea Stewart-Cousins.