A recent story in the New York Times reported that a number of states are introducing legislation that restricts how narcotic painkillers are prescribed. Noticing the rising death toll caused by these drugs, elected officials have (finally) become frustrated with the lack of federal action.
Painkillers like OxyContin, Percocet and Vicodin were not legal or available in Australia until after I moved away, so my personal experience with these drugs is (thankfully) limited. I have, however, heard many accounts by American former pill-poppers of doctors handing out super-sized bottles of narcotic painkillers as if they were candy. But don’t take my word for it. According to the New York Times piece, some doctors and dentists give up to 90 pills containing, for example, oxycodone, at a single appointment.
Do No Harm?
Prescription painkillers killed over 14,000 people in 2014, according to the CDC. That’s a 14 percent increase from 2013. And addiction isn’t the only risk; opioids can also cause sleep apnea, drastically reduce hormone production, increase sensitivity to pain and result in overdose.
The beginning of this epidemic can be traced back to the 1990s, when pharmaceutical companies claimed opioids could be used without fear of addiction. (Yes, really.) But though the obvious fallacy of this claim has become apparent over the decades, solutions have been deadlocked. Fun fact: prescription opioid sales reached an estimated $1.98 billion in 2014. Seems like treating a public health crisis is trickier when profits are at stake.
Regulating Shit That Can Kill You is a Good Idea
On one side, patient advocacy groups and some in the medical community argue that regulations punish those with legitimate need. Some of these groups also claim there’s little scientific data to support major restrictions, and that new laws only push people into trying heroin. (Counter-arguments point to the fact that heroin use was spiking before opiates ever came onto the market.) Thankfully, these arguments are losing steam. If you disagree, re-read the stats in the last section.
No one’s saying that people in real pain shouldn’t have access to medication, but rather that, due to the high risks associated with use, the prescription process should be more closely controlled. In fact, every state but Missouri has a voluntary prescription-monitoring program to stop people getting their supply from multiple doctors.
Unfortunately, the ‘voluntary’ part of these programs means many doctors don’t bother checking the database. In places like Kentucky where checks are mandatory, prescriptions of opioids fell 8.6 percent in one year, according to researchers at the University of Kentucky Lexington. Does that mean doctors are weeding out potential and actual substance abusers? Or that these prescriptions were far too easy to write, and this regulation is akin to putting the cookies on the high shelf? (You have to really want them to take that extra step.)
The Power of Big Pharma…Fading?
There are currently 375 proposals in state legislature that would regulate some aspect of the pill-taking process. Most recently, Massachusetts passed a bill that drastically reduces the amount of pills a doctor can prescribe to a seven-day supply. Vermont and Maine are expected to take similar action in the summer, developing a new approach for regulating the pain management process post surgery or injury.
Claiming prescription guidelines like those in Massachusetts were developed behind closed doors, some pharma-funded doctors and patient groups want to delay regulations until more scientific evidence supporting them is published. Personally, I think that’s like waiting to get diabetes before cutting back on sugar. Vermont governor Peter Shumlin agrees. In a recent interview, he stated that individual states need to take action, as Big Pharma lobbyists can (and will) block federal attempts.
In some good news, the CDC is also expected to issue new guidelines for limiting pill prescriptions and treating pain with alternative therapies, upsetting the deadlocked status quo. Even staunch opponents of being told what to do are softening up. Dr. Dennis Dimitri, the president of the Massachusetts Medical Society, said that though “Usually we are opposed to carving anything in stone that has to do with medical practice,” they are willing to accept the new limitations, “Because we recognize this is a unique public health crisis.”
Good luck, everybody.
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