If you looked up the statistics of the drugs that cause the most fatal overdoses in New York (and the country as a whole for that matter); you may be surprised at the overall ‘winners’. The number of emergency-room visits that were directly related to prescription medication abuse such as Ativan, Valium and Xanax has exploded according to the latest city Health Department analysis. The latest statistics showed that the number of emergency room visits increased to 6,555 – which represents a 111% increase in only six years (2004 through 2010).
The number of overdose deaths attributed to sleeping pills/anti-anxiety medication also increased through that period by 18%, standing at 226 in 2010. These cases alone make up 44% of all overdose deaths in New York.
Problems with Perception
Part of the problem is the notion that prescription-drug misuse is somehow safer than, or not as illegal as, the abuse of “street drugs.” The truth is that when abused, prescription medication can have a devastating effect on someone’s life. While most people have always been warned about the addictive potential of heroin or cocaine, until the 1970’s Valium was referred to as “Mother’s Little Helper” in order to relieve anxiety throughout the day. It is far too easy for people to have access to these substances through the Internet, the medicine cabinet and through prescriptions.
Too Easy to Obtain
The problem is that our current health care system also makes it too easy to prescribe painkillers. Even though the perception is slowly starting to change and physicians are being placed under more scrutiny when it comes to prescribing medication, many physicians have become too reliant on certain medications or sometimes prescribe them because of potential pharmaceutical company bonuses.
The class of medications most widely prescribed throughout the nation is opioids – high-strength painkillers. Over the last decade alone, the number of opioid prescriptions has increased by almost 400%. However, the long-term risk or effectiveness of these opioids has limited evidence according to federal research data. These painkillers are prescribed in doctors’ offices throughout the country for a number of different issues; including arthritis, back injuries and other health issues.
However, these opioids are not without risk either. Aside from their addictive potential, they increase the risk for falls and hip fractures for the elderly, cause sharply reduced hormone production and may lead to sleep apnea. The worst-case scenario is a fatal overdose for the person taking too much.
Medication Abuse is a Growing Problem
Recent studies suggest that there are hundreds of thousands of people throughout the nation that are currently taking dosages of opioid painkillers that should be considered ‘potentially dangerous’. There is no denying that opioid pain relievers are able to provide relief for countless patients. We also cannot deny the fact that the vast majority of doctors prescribe these substances in a responsible way. However, there is a problem when physicians keep their patients on drugs for several years. This is especially true if these drugs were only meant to provide temporary relief for an actual, physical problem. The long-term user may begin to develop a powerful psychological dependence.
We Must Make Changes
It can be difficult to change old habits, this goes for both patients and doctors alike. However, certain states are already imposing stringent guidelines. For example, the new requirements in Washington force doctors to defer those patients currently on high dosages of opioids (including oxycodone, methadone, fentanyl and hydrocodone) to a pain specialist when the underlying condition for which the patient is being prescribed opioids does not improve over time.
Of course some measures are becoming excessive, refusing to refill prescriptions for patients who have struggled with the same painful disease for decades, but the federal Centers for Disease Control and Prevention have been urging physicians to take a more judicious approach when prescribing opioids. In 2008 alone (the most recent year with available data), there were 14,800 Americans who died as a direct result of incidents that involved prescription painkillers.
A Relatively New Problem
Even though it has become common practice rather quickly, the approach of using opioids to help patients deal with chronic pain is a relatively new concept. In fact, about 15 years ago opioids were reserved for end-of-life care, cancer pain, or postoperative pain. However, considering they were extremely effective in dealing with these issues, pain experts argued that these painkillers should be used to treat all types of long-term pain. They claimed it was a drug that came with little risk of addiction and yet many benefits.
This was around the same time that pharmaceutical companies promoted the newer strand of opioid formulations such as OxyContin for chronic pain. The promotion no longer focused on end-of-life care, cancer, or postoperative pain, but rather on replacing traditional painkillers at greater strengths. According to the consulting firm IMS Health, sales of prescription pain medication reached $8.5 billion last year. Compare that to the relatively ‘meager’ $4.4 billion in 2001. As is to be expected with such massive financial gains, the pharmaceutical companies are not exactly eager to give up their source of income without a fight.
There is no denying that opioids have a place in modern medicine. For those struggling with long-term or chronic illnesses, it can be a blessing and provide relief. However, there is no ignoring the issues with opioids any longer. The moment that a specific type of substance is responsible for the largest amount of fatal overdoses in the country, it is time to take a step back and wonder why we are not acting faster.
We need to recognize that the potential for abuse with these pain relievers is far too great. We need to understand that certain health problems will have to be dealt with in a different way – the risk-reward calculation needs to be made again and include the information that we have today, not the information that pharmaceutical companies were pushing two decades ago.