Physicians should prescribe opioid painkillers less often, in lower doses, and for shorter duration. The CDC recently issued prescribing guidelines that discourage use of opioids for chronic pain. It also advised that for acute pain, treatment for three days is usually sufficient and that treatment for more than seven days is rarely necessary.

Physicians should use great caution when prescribing opioid pain relievers in patients who are also taking benzodiazepines and should avoid prescribing benzodiazepines in patients taking opioids because the combination of benzodiazepines and opioids is so dangerous.

Physicians should help their patients who are dependent on opioids get treatment. This can be through referral to methadone treatment or prescribing buprenorphine (Suboxone™), an opioid-like medication that reduces withdrawal symptoms and is safer than methadone. With readily available training and certification, office- or clinic-based physicians can prescribe buprenorphine.

People in contact with those who use opioids should obtain the antidote naloxone (Narcan™), which can immediately reverse a potentially fatal opioid overdose. In 2014, Pennsylvania’s Physician General Dr. Rachel Levine signed a “standing order” for naloxone. This action, combined with passage of PA Act 139 of 2014, is intended to expand access to naloxone by first responders and families and friends of opiate users.

In April 2016, the Pennsylvania Department of Health joined other state health agencies and professional organizations in requesting that Medicare, Medicaid, and hospital accreditation programs roll back aggressive pain management rules that require hospitals to ask every patient about pain routinely — a practice that has prompted overuse of opioid pain relievers.

Suggested citation: Philadelphia Department of Public Health. Overdose deaths involving opioids in Philadelphia. CHART 2016;1(1):1–8.

This report produced in collaboration with the Urban Health Collaborative of the Dornsife School of Public Health, Drexel University.

CHART is a publication of the Philadelphia Department of Public Health, and is intended to highlight under-reported or under-appreciated public health issues in an effort to kick-start a conversation. Readers can subscribe to CHART on Medium, or on our website.