This week, the White House rightly criticized an ad, which aired during the Super Bowl, designed to promote a drug to treat opioid-induced constipation. White House Chief of Staff Denis McDonough and other officials blasted the ad, saying that the pharmaceutical companies should be running ads combating addiction, not fueling it. The danger of these kind of ads is that they normalize the use of opioid-based prescription painkillers, the overprescribing of which is the main driver fueling the epidemic of addiction to opiate-based painkillers and heroin
Nearly 29,000 people died of overdoses from opioids in 2014, according to the Centers for Disease Control and Prevention (CDC). It is the No. 1 source of accidental death in the United States and in New Jersey. Yet the airing of ads, such as the Super Bowl ad, highlights the fact that even though some strides have been made, the fundamental change in prescribing practice needed to curb this epidemic has yet to take hold.
As a recently released Johns Hopkins University School of Public Health Report on the Opiate Epidemic, which strongly recommends tightening up prescribing practices, notes, “Doctors often prescribe pain medications in quantities and for conditions that are excessive, and in many cases, beyond the evidence base.” And 85 percent of doctors themselves say that opiate-based pain medications are over-prescribed.
Recognizing this fact, CDC draft guidelines recommend that “before starting and periodically during opioid therapy, providers should discuss with patients known risks and realistic benefits of opioid therapy and patient and provider responsibilities for managing therapy.” We are pleased that these draft guidelines, a product of top doctors and addiction experts, are likely to be published soon and so far the CDC is resisting efforts to water them down.
Still, given the epidemic, simply issuing guidelines does not go far enough. That is why, as a new state legislative session begins, we will continue to push hard for legislation that reflects this recommendation of top medical experts and requires doctors to discuss the risks of addiction with patients. We will begin by urging the state Legislature to adopt a law that provides parents with the critical information needed to make an informed decision about whether their teenager should be prescribed an opiate-based painkiller, by requiring that physicians and other prescribers discuss the potential risks of dependency before writing a prescription as well as, where appropriate, discuss potential alternative treatments. When parents make a decision to go forward with an opiate prescription, this essential parent education provides the added benefit of alerting them to be on the lookout for any signs of dependence developing.
A more expansive version of this legislation, put forward by Senator Loretta Weinberg (D-Bergen) and Senator Joe Vitale (D-Middlesex), which requires a conversation with adult patients as well, passed the state Senate overwhelmingly at the end of 2014. Yet it failed to receive even a hearing in the state Assembly before the end of the recently concluded session.
As the epidemic proceeds apace, we urge the New Jersey Legislature to act on this and other prevention initiatives. Delay, unfortunately, means more ruined lives and avoidable deaths.