Thirty years ago, I attended medical school in New York. In the key lecture on pain management, the professor told us confidently that patients who received prescription narcotics for pain would not become addicted.
While pain management remains an essential patient right, a generation of health care professionals, patients, and families have learned the hard way how deeply misguided that assertion was. Narcotics - both illegal and legal - are dangerous drugs that can destroy lives and communities.
Millions of Americans struggle with substance abuse. Across the United States, overdoses involving opioid painkillers - a class of drugs with narcotic effects that includes hydrocodone, methadone, oxycodone - have skyrocketed in the past decade.
Today, the United States consumes most of the world’s supply of opioid painkillers. By 2010, enough opioid painkillers were prescribed to medicate every American adult around-the-clock for a month. And every year, nearly 15,000 people die from overdoses involving these drugs... more than from heroin and cocaine combined.
Studies by scientists at the Centers for Disease Control and Prevention and elsewhere show that most of these deaths are not the result of people taking small doses of opioids for a short time. Typically, problems arise when people take large amounts of painkillers or use them over a long period of time.
About 1 in 20 people in the United States age 12 or older reported using opioid painkillers for non-medical purposes in 2010. Some of these people engage in doctor shopping - getting prescriptions for commonly abused drugs from several practitioners in a short time and having the prescriptions filled at several pharmacies. In this way, people can obtain dangerous amounts of a prescription drug rapidly.
And in addition to the heavy toll this can take on lives and communities, non-medical use of prescription painkillers costs health insurers up to $72.5 billion annually in direct health care costs.
We can do more as a society to help prevent overdoses involving prescription painkillers while making sure patients who need them have access to safe, effective treatment.
Health care providers should prescribe opioid painkillers only under specific conditions, as in the treatment of chronic cancer pain when other treatments have not worked, and in limited quantities.
Providers can also screen patients for risk and history of substance abuse before prescribing opioid painkillers. Drug addiction is a disease of the brain that can be treated.
But health care providers aren’t the whole answer. Insurers and health care institutions must set up systems to identify and take action when providers or patients are using prescription drugs in dangerous ways. Some states have passed laws to rein in rogue pain clinics (“pill mills") run solely for profit, that attract drug shoppers from other states.
Individuals can help protect themselves and others by doing the following:
– Talk with your provider about alternatives to opioid painkillers.
– Use opioid painkillers only as directed by a health care provider.
– Make sure you are the only one to use your painkillers. Not selling or sharing them with others helps prevent misuse and abuse.
– Store opioid painkillers in a secure place and dispose of them properly.
To learn more about prescription painkiller overdoses, join Dr. Frieden on Twitter @DrFriedenCDC today at 2 p.m. ET
http://thechart.blogs.cnn.com/2012/02/24/cdc-director-we-are-not-powerless-against-prescription-drug-overdoses/?hpt=he_c2
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