Opioid Epidemic Chat with Dr. Hooten

Thu, Sep 22, 2016
1:00pm to 2:00pm ET


On September 22, Dr. W. Michael Hooten, an anesthesiologist and pain management expert at Mayo Clinic, hosted a live discussions about opioids. Public health experts call the Opioid Epidemic a serious public health issue. Learn more about:

  • What are opioids and what do they do
  • What are the concerns for use and misuse
  • How do people become addicted
  • What help is available to manage chronic pain

Additional opioid information from Mayo Clinic

Mayo Clinic Minute: Prescription drugs - the changing face of addiction

Mayo Clinic Minute: Facts on fentanyl

Mayo Clinic Minute: Avoid opioids for chronic pain

Mayo Clinic Minute: 2 reasons not to share pain pills

Mayo Clinic Minute: When are opioids OK to take?

Mayo Clinic Minute: What opioids do to your gut

Mayo Clinic Minute: How to stop popping painkillers





Is there a link for the discussion?


I cannot find a link which informs me on how to listen on 22nd or how to post a question.


Hi @missyb57, @sunshineme, @dawn_giacabazi and @jennsprung, you can post your questions in advance right here for Dr. Hooten. Simple click REPLY. On Sept 22, return to this page to watch the video and ask questions real time.

You can also sign up for the event to receive email reminders the day before and 1 hour before the event starts. Sign up here: http://mayocl.in/2cfkxOg.


Good morning Dr. Hooten.
Patients with CYP450 pharmacogenetic variations may respond differently to opioids, ranging from drug unresponsiveness to toxicity with elevated serum levels. The administration of opioids may be associated with adverse drug reactions including sedation, dizziness, nausea, vomiting, constipation, physical dependence, tolerance, and respiratory depression. By performing pharmacogenetic testing, patients can be dosed appropriately to avoid experiencing dose-dependent side effects or lack of drug efficacy. What role if any do you feel Pharmocogentic testing may play in the prescreening process for prescribing these drugs to patients?


Is it srtil going to be great?


I meant today


Uh never mind wrong day
so sorry


Are there new medications on the horizon to replace opioids since the government seems to be anxious to remove them from the market? It seems that people will find illegal remedies if they are no longer able to get prescriptions to assist with pain management.


What is your opinion regarding the legalization of cannibus for pain management? Iowa is especially behind in legislative acceptance with the approval for only three “situations” yet no dispensaries and no legal transport across state lines. Minnesota is a step ahead with limited situations and dispensaries yet Mayo Clinic in Rochester is not prescribing for their own patients, at least not through the Department of Rheumatology. What options do people in great pain have?


What are the real risks for people who need opioids? For example, if one takes two 3/525 hydrocodone tablets three times per day…along with two Extra Strength Tylenol for each hydrocodone to increase the effect, is this damaging to the liver and other organs? The government has limited the dosage to 3/525 due to overdoses, yet the doctors and pharmacists are telling us to add our own Tylenol!!! This seems worse than getting the pills pre-formed with the appropriate dosage! I would appreciate your advice. Thank you!


After a recent out-patient surgery, I felt so much overall relief. I asked what was in the surgical IV and was told that it must have been the Fentenyl that alleviated my pain. I requested patches and now use a 25 mcg and also a 12 mcg patch (at the same time) every three days. I also need two 3/525 hydrocodone pills plus two Extra Strength Tylenol (as per my physician and my pharmacist’s recommendation) to assist with high levels of pain from scoliosis, severe rheumatoid arthritis, fibromyalgia, neuropathy and Lyme Disease symptoms. I am very concerned about my pain levels but I am also worried about my liver!!! Once in awhile, I need a shot of whiskey to “tame my system”….I also take a Xanxa (.25) or two to sleep. I have tried Cannibus while on vacation as it is illegal in my state. It only seems to help if I take it before my pain levels exasperate. I have taken the condensed Pain Clinic class at Mayo without any help from it — I took it when it was new and they had us sit on hard folding chairs while they showed us a PowerPoint Presentation. I am not willing to return due to the extreme cost of living in Rochester for three weeks, etc too…..I do yoga; I have regular weekly massages; I have tried Rolfing; I have tried acupuncture; I have tried chiropractic; I have had multiple spinal injections; I have had 34 surgeries. I am still in great pain and I have to plan my family life around this situation. I have a very relaxed lifestyle as I am on disability and take time to take care of my body with healthful eating and treatments. I do not know what else to do! Any advice would be greatly appreciated. Thank you so much!


Is Tramdol a opioid ?
Jeanne Harmon


f simply paying closer attention to the patient on chronic opioid therapy allows providers to provide better care, to prescribe more confidently, and by “paying closer attention” I mean adhering to all of the many new guidelines, prescribing rules, and best practices published over the past few years and discussed today, then why does study after study show doctors aren’t following these best practices today and why won’t leading provider organizations like the AMA and the AHA come out in favor of required prescribing protocols? In other words, what do you think it will take to really engage the provider community in taking more concrete steps to prevent misuse in the first place instead of advocating for things after the fact — like treatment after addiction or naloxone after overdose?


Your remarks rang a bell with me @ajacobskind, because you reflect pretty well how I felt a month ago. Today, I’m not so certain. In general, you’ll probably agree that painkillers should be readily available to the millions of people who need them. You may agree, as well, that cannabinoids should be readily available everywhere for medical purposes. I’m not personally affected by either class of medications, but I am personally incensed by the extend and depth of suffering that people endure as a consequence of government bungling, cultural obsolescence, and medical carelessness.

The opiod epidemic needs to be discussed in light of the latest report from the federal Substance Abuse and Mental Health Services Administration on the current epidemic of painkiller use. Here’s the link: http://www.samhsa.gov/data/sites/default/files/NSDUH-FFR2-2015/NSDUH-FFR2-2015.htm.

Within the fertile data fielded here is the following statement: “Most painkiller use isn’t misuse, which SAMHSA defines as any use of painkillers in a manner not directed by a doctor.”

How’s that for a policy declaration? Misuse (or abuse) doesn’t occur when the substance is used as “directed by a doctor.” The problem you cite is a little different — you’re actually talking about abuse resulting from medical professionals who don’t care or bother to give directions for the use of the painkillers.

So I’m with you on closing down those avenues for putting painkillers on the streets without diligent medical directions, so long as you’re with me on opening the outputs further for providing painkillers for so many who need them to make their lives bearable.


@predictable. Scientific insight must strike the right balance between providing maximum relief from suffering while minimizing associated risks and adverse effects. By making pharmacogenetic testing standard procedure before prescribing the opiates or other habit-forming drugs we would significantly decrease the amount of misuse, would you agree?


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