Cutting off the opioid epidemic at the root
IT’S BEEN nearly two years since the state declared prescription drug and heroin addiction a public health emergency. Since then, we’ve had an all-hands-on-deck approach from lawmakers, police and fire chiefs, health professionals, and community groups.
But our collective efforts haven’t been enough. Until we change the culture around how opioids are prescribed, and dramatically reduce the number of pills available, people will continue to die.
Since 1999, the number of prescription painkillers sold in the United States has nearly quadrupled. In 2014, there were 4.6 million opioid prescriptions written in Massachusetts alone — enough for nearly every adult in this state to have a bottle of pills. Meanwhile, overdose deaths have risen by more than 300 percent.
We won’t solve this crisis until we cut it off at its root, by reducing the use of prescription opioid painkillers like Oxycontin, Vicodin, and Percocet. Cheap heroin is not a new problem; it’s been around for decades. What is new is that four out of five heroin users report having previously used a prescription opioid. These powerful drugs are a synthetic version of opium. They’re heroin in a pill.
The opioid epidemic is the direct result of years of overprescribing painkillers to everyday people, who get hooked on an extremely addictive substance, then turn to heroin when they can no longer afford to sustain an expensive pill habit.
While heroin is certainly a problem, three times as many Americans are hooked on opioids. Pharmaceutical companies told us for years that they weren’t addictive, but we know better now. Medical studies have shown that up to a third of long-term opioid users meet criteria for addiction, and that physical dependence can happen in as few as five days.
While the vast majority of prescribers are trying to do the right thing, we must end the illegal prescribing we know is taking place. My office has formed an investigative group to identify practitioners who are illegally prescribing opioids to people who shouldn’t have them. This partnership will allow state and federal law enforcement agencies to share information about those who run “pill mills” or prescribe to people with a history of substance abuse.
But to combat the opioid crisis more fully, we need societal change. The Centers for Disease Control and Prevention has proposed nationwide guidelines to help medical professionals across the country understand when and how opioids should be used, particularly for chronic pain. The pharmaceutical lobby and some sectors of the medical community have pushed back against these guidelines, calling them too restrictive. But here’s my view: Thousands are dying, and something desperately has to change. Thirty-six other state attorneys general share that view and recently wrote a similar letter in support of the guidelines.
There’s another simple solution that can be put in place immediately: We need prescribers to check the state’s prescription monitoring program every time they write a prescription for highly addictive drugs. The program can flag when a patient is receiving multiple prescriptions, doctor shopping, or showing signs of addiction. Right now, only one in four doctors checks. Governor Baker has proposed that all prescribers check the prescription monitoring program every time they write one of these prescriptions. When New York State passed a similar mandate in 2012, it saw a 75 percent drop in doctor shopping. This modest step can save lives and is time well spent.
Those who continue to push back against safeguards like these should spend time with any of the thousands of parents across this state who have lost a child to opiate addiction. All too often, theirs are stories of high school athletes and honor roll students who became hooked on opioids after an injury. Others began by experimenting at a party — but if our medicine cabinets weren’t full of prescription painkillers, our kids wouldn’t have such easy access to them.
We can’t hear those stories any longer and fail to act. Other countries have figured out how to manage pain without releasing a flood of dangerous drugs into their communities. We need to do the same. If we don’t, the deaths will continue.
Filed under: General Problems
I am just disgusted by the bias of these so called authorities. The actions of the Governors and other members of Congress that gather in focus groups to push for this type of legislature should be deemed unconstitutional, and as much as it makes me want to run screaming even to suggest it, the ACLU should be all over this. There is widespread media coverage of several members talking of losing a child or other loved one to heroin addiction, alcohol, meth or some mixed party pill overdose. While I sympathize with their loss and feel for the unimaginable grief and guilt that they must feel, and, even applaud ‘taking up the sword’ to advocate on behalf of said tragedy I cannot accept the use of power and platform for personal gain, even at the hand of loss. I’m sorry if that sounds cold. But someone please make sense of this to me as I don’t understand how and why they are allowed to vote on such things. Think in terms of how we vet a jury panel in this country when someone’s life is on the line for trial. We take our judicial system in this country very seriously during the trial process. Should the legislative side be any different? When a conflict of interest, personal bias or any issue arises that would sway a decision in the process, shouldn’t our elected officials be morality, ethically and legally bound to recuse themselves from the conversation?
I was accused of dr shopping it’s sad being in pain and nothing controls it I can tell you however today I only use kratom and skullcap and these 2 herbs work better than oxy’s opana and fenyntal all together the magic about these herbs is there is NO respiratory depression so the risk of death does not exist.