Op-Ed: Prevent Opiate Addiction at the Source Through Educating Patients
Over the past two decades, the number of prescriptions for opiate-based painkillers has tripled, while dosages have grown stronger
The prime source for the national explosion of opiate addiction -- whether in the form of painkillers such as OxyContin or in the form of illegal street drugs such as heroin -- is the dramatic increase in the use of opiate-based prescription drugs. Over the past 20 years, there has been a threefold increase in the number of prescriptions issued for opiate-based painkillers, as well as a major step-up in dosage, according to the Centers for Disease Control and Prevention (CDC). Healthcare providers wrote 259 million prescriptions in 2012 alone. Further, it has been well-documented that some people when they can no longer get access to prescription painkillers feed their opiate addiction by turning to heroin.
The costs in lost and ruined lives from what the CDC refers to as a “national epidemic” of opiate addiction continue to rise. Drug overdoses are the number one cause of accidental death in the United States. In 2010, nearly 20,000 people died from an overdose of opiates -- nearly 17,000 from prescription painkillers and an additional 3,000 from heroin. It is time for a comprehensive approach that matches the scale of the problem and that begins at its source—the overprescribing of prescription painkillers and the underinforming of patients about the risks of this medication and possible alternatives
We are pleased to report that there is legislation moving through the New Jersey legislature that does exactly that. Senator Loretta Weinberg (D-37th) and Senator Joe Vitale (D-19th) are putting forward a proposed law (S-2366) requiring physicians and other health practitioners to discuss with a patient the risks of physical and psychological addiction and the availability of potential alternative medications, before issuing a prescription for an opiate-based painkiller.
In cases where the patient is under 18 years old, this discussion must take place with a parent or a guardian From the harm that too many of our children and families have experienced because a teenager becomes addicted to opiates, we know just how important providing this essential knowledge can be. To ensure compliance with the essential provisions of this legislation, the practitioner must obtain a written acknowledgement from the patient or the patient’s parent or guardian that this discussion has taken place.
The need for moving forward with this kind of approach is underscored by the American Academy of Neurology’s recent determination that the risks of powerful narcotic painkillers outweigh their benefits for treating chronic headaches, low back pain, and fibromyalgia. The Academy noted that 50 percent of patients who took opioids for at least three months are still on them five years later.
Further, more appropriate and limited prescribing of prescription painkillers will help reduce heroin use by reducing the number of people who crave opiates. AS CDC Director Tom Frieden, M.D., M.P.H., said, “Addressing prescription opioid abuse by changing prescribing is likely to prevent heroin use in the long term
Just as importantly, there is strong public support in New Jersey for this approach. In a recent FDU Public Mind Poll, more than two-out-of-three New Jersey parents indicated support for a law requiring that they be notified if their child’s prescription contained potentially addictive medication
We are pleased to report that this legislation, one component of a comprehensive package aimed at taking on New Jersey’s addiction problem passed the Senate recently, by a margin of 36 to 1. Still, there is a long way to go before final passage and it will require all of us to make our voices heard. It is particularly important for people to communicate their support to their Assembly members, since that is the next hurdle, we anticipate an open and fair discussion of this legislation in the Assembly Health Committee chaired by Assemblyman Herb Conaway (D-7th) soon after the New Year.
Senator Weinberg and Vitale’s legislation (S-2366 ) is a critical prevention measure which attacks the problem directly at its source. Treatment after the fact is still important to do, but because of the brain changes caused by opiate addiction, it is a hard, difficult road to recovery for too many and the results are hit or miss. We must put preventing addiction in the first place at the forefront and that begins with passing this essential measure.