Prescription drug abuse has been an epidemic in the United States for the past decade, and it is one that has not gone unnoticed. The medical community, law enforcement at both the state and federal levels, and local communities in every part of the country have all come together to attack the problem from different angles.
Through their combined efforts, significant legislative changes have taken place with the goal of:
- Reducing the rate of overdose among current prescription painkiller users
- Identifying prescription drug users who are addicted to their medication and/or abusing the system in order to get or sell extra pills
- Reducing the rate of new cases of painkiller addiction
- Increasing awareness of the dangers related to prescription painkiller use and abuse among patients and prescribing physicians
What are these legislative changes, and are they working? With an estimated 50 people losing their lives to painkiller overdose every day and more than 2.1 million Americans addicted to these medications, these are questions that need to be answered.
Prescription Drug Databases
More and more states have implemented statewide prescription drug databases over the last decade. In some states, they have mandated all physicians who prescribe addicted drugs to utilize and update these databases when they prescribe painkillers and other addictive drugs. The idea is that if all physicians and pharmacists in the state can access a single database in order to see the details of the prescriptions a patient has, then signs of abuse and addiction will be noticed and addressed.
For example, if a patient attempts to alter a written prescription for 10 oxycodone pills and turn it into 100 pills, and a pharmacist checks the database to see that the prescribing physician entered just 10 pills into the database, he can then call and double check to ascertain which one is incorrect and act accordingly. When fraud is identified, it is often a sign that the pills are being abused, and appropriate action can be taken to connect the patient with treatment.
Similarly, if a patient goes to the doctor complaining of pain and seeking medication, the doctor can check the database to see if that patient is already getting a prescription from another prescription. Too often, patients are able to get multiple prescriptions for addictive drugs simply by seeking care from prescribers who never know that they are duplicating another physician’s prescription.
So does it work? The numbers say “yes.” According to BusinessInsider.com, in 2012, New York implemented a statewide database and required prescribing physicians to use it. As a result, by 2013, there was a 75 percent drop in the number of patients seeking addictive medications from multiple doctors. Additionally, when Tennessee also required prescribing doctors to utilize their statewide database, there was a 36 percent drop in patients seeking drugs from multiple doctors.
In other states, however, where physician use of the statewide prescription databases is not required, the success rate is much lower.
Abuse-Deterrent Versions of Pills
Many people who abuse prescription painkillers and inadvertently overdose on the medications do so by crushing the extended-release versions of the drug in order to get multiple doses designed to be released over a 12-hour or 24-hour period all at once. Whether they swallow it, snort it, or dissolve the powder in water and then inject it, the end result is a whopping dose of an extremely potent and deadly drug.
In order to limit prescription drug abuse of this nature, the FDA has often required drug manufacturers to create “abuse-deterrent formulations” (ADFs). These pills are not easily crushed, some turn into a gel when the insides of the pill meet water, and others release an abuse-deterrent medication designed to block the “high” caused by the opiate ingredient.
Does this method of prescription pill abuse prevention work? Some say “yes” and some say “no.” Naysayers argue that only the most serious drug abusers crush pills before taking them. They point out that most people who abuse pills do so by simply swallowing whole more than they are prescribed, or take the pills without a prescription, and neither action is deterred with these versions of the pills.
Perhaps the real deterrent is in the increased cost. Opiate pills are already expensive, but the ADF versions are considerably more expensive due to the increased manufacturing cost. If people can’t afford them, abuse of the drugs will certainly be less common.
Increased Funding for Drug Addiction Treatment Programs
The budget proposal from the Obama administration for 2016 provides for an increase in funding for departments and services designed to fight prescription drug abuse, according to The HilI. The funding would increase the programs available through the Centers for Disease Control and Prevention (CDC) and the Substance Abuse and Mental Health Services Administration (SAMHSA) as well as other government agencies. Prescription drug monitoring databases would be implemented or improved as needed with this funding as well. Additionally, some of the money would go to increasing access to naloxone, a drug proven to be effective in stopping an opiate overdose before the overdose becomes deadly.
In the budget summary it was stated: “Every day, more than 100 people die as a result of drug overdose, and more than 6,700 are treated in emergency departments. Abuse of prescription and illicit drugs, such as heroin, is an urgent public health concern.”
Prescription drug databases are working when they are used. Abuse-deterrent formulations of medications may be helping to fight the problem as well. Naloxone is working when it is available and used appropriately. Though there is no single answer to the problem of prescription drug abuse and addiction, it’s clear that all the measures taken thus far are helping to move the country away from prescription drug abuse, addiction, and overdose one step at a time.