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Abuse of Prescription Painkillers
Posted By Horizon NJ Health on February 12, 2014
Tags: Prescription, Painkillers
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Pius Chikezie, MD, MPH, FACP, Medical Director, Horizon NJ Health

Q. A few weeks ago I heard about how some pharmacies are being robbed to get painkillers such as OxyContin. And I also know that many athletes and other celebrities, have been treated for addiction to painkillers. What can you tell me about painkiller abuse? Is it a serious problem?

A. There is most definitely a problem with abuse of painkillers – specifically opioids - in this country. Opioids are strong painkillers used to treat severe pain linked with chronic conditions such as rheumatoid arthritis, cancer, and nerve pain caused by injuries and accidents. Some of the most well-known medications of this type are OxyContin, Vicodin, codeine, oxycodone and hydrocodone, and a major problem with all of these drugs is that they can quickly cause those who use them to become addicted. One study, just released in October 2013, states that the rate of prescription drug overdoses in this country has quadrupled since 1999. In fact, since 2003, more people have died from abusing these drugs than those who used heroin and cocaine combined.

The federal government, in fact, has referred to an increase of abuse of these drugs as an “epidemic” and has stated that this type of abuse is the fastest growing drug problem we have in the United States. Doctors, public health officials, pharmaceutical companies, police and courts have all noticed a recent increase in abuse of these drugs. This is a serious problem, because a high demand for these addictive drugs causes overprescription by some doctors. It also leads to an increase of armed robberies of pharmacies, which can lead to the drugs being sold on the black market to addicts who want them for their personal use. Another serious problem, doctors and other officials say, is that often the overuse of painkillers can lead some addicts to try street drugs such as heroin. And for each death related to opioid abuse, there is a large increase in people who go to emergency rooms for treatment as well as an increase in the number of people who need treatment for substance abuse. It is also true that at least half of the people who abuse opioids are not getting prescriptions for the drugs before they use them.

In response, the Food and Drug Administration (FDA), which regulates the distribution and use of prescription medicines in this country, has been trying to get doctors to restrict the way in which they prescribe these medicines. This move, encouraged by the American Medical Association (AMA), has led to the recommendation that “patients should not be prescribed long-acting or extended-release opioid pain relievers unless they need daily, round-the-clock care for pain that can't be managed by any other means.”

What this means is that doctors are not being given formal, legal restrictions on the way they prescribe opioid painkillers. Instead, the FDA is trying to get doctors to think long and hard before they prescribe the medications for anything other than ongoing pain that is impossible to treat using other means. There are also steps the FDA is taking, working together with the Drug Enforcement Administration (DEA) that will increase the education requirements for prescribers. A doctor or other professional who prescribes opioids will have to prove that they have received an adequate amount of education about these drugs and their risks before they are approved to prescribe them. The DEA, working with the FDA and law enforcement, will also institute better measures to track and monitor the movement of these drugs from manufacturer to pharmacy to patient. As well, doctors who incorrectly allow these drugs to circulate to the wrong people may find themselves being punished.

The Centers for Disease Control (CDC), another federal agency, has tried to educate doctors and patients about proper, safe use of painkillers. The measures taken include educational programs that teach patients about the potential risks of addictive medicines and give them information about how to properly dispose of used painkillers.

If you are prescribed painkillers, it is very important for you to make sure you follow the prescription instructions exactly as they are given to you. Talk to your doctor about painkiller addiction. Also make sure you keep the medicine in a secure location and, if you have extra pills, ask your pharmacist about disposing of any extra or expired pills.