A widely used medical reference tool for administering drugs, is so inaccurate, two prominent doctors call it "the death table" because of the more than 15,000 estimated deaths from overdoses they associate with it each year.
Dr. Perry Fine of the University of Utah and Dr. Lynn Webster of Lifetree Clinical Research in Salt Lake City co-authored a review of medical literature and forensic reports published in the journal Pain Medicine that evaluates "equianalgesic conversion tables" -- a tool that helps physicians calculate dosage when a patient switches from one pain medication to another.
According to Desert News, the two men are well-known and respected in the field, as Fine was the past president of the American Academy of Pain Medicine and Webster is president-elect.
Desert News reports Webster as saying the tables are "notoriously inaccurate":
"We've been taught that these equal analgesic tables are reasonably safe, as a guide," Webster said. "And they're not."
"And that's why we're basically on a campaign nationally to make sure that every physician who prescribes an opioid understands they can't use these conversion tables," he said.
The equianalgesic conversion tables are used when a patient needs to switch opioid pain medications for reasons that can include side effects, tolerance and insurance matters. Doctors use these tables to prescribe another drug at the proper dose to try and achieve a similar effect as the previous medication.
Opioids are used for moderate to severe pain. According to the Food and Drug Administration, 33 million Americans age 12 and older misused extended-release and long-acting opioids in 2007. The FDA estimates that opioids were responsible for nearly 50,000 emergency room visits in 2006.
When you hear the word opioid, which includes methadone, morphine, and oxycodone, you may be thinking these death rates are attributable to those who are addicts or long-term users. Webster said this isn't the case:
"It could be somebody who's been on pain medication after a hip operation or a knee operation for several weeks and it's not working any more," Webster said. When a physician uses the conversion tables to estimate the proper dose, "It could be very far off from what's safe."
To help combat this problem, Webster suggests a gradual phase in of the new drug and reducing the recommended dose.
“Our primary objective is to increase understanding of the major risk factors associated with opioid-related deaths and exploring methods that mitigate the adverse effects involved in treating patients with analgesics that are potentially lethal," Webster said in a statement.