Scott Krakower, D.O., is a child and adolescent psychiatrist at North Shore-LIJ's Zucker Hillside Hospital in Glen Oaks, N.Y. He is also assistant professor of psychiatry at the Hofstra North Shore-LIJ School of Medicine.He contributed this article to LiveScience's Expert Voices: Op-Ed & Insights.
Patients approaching physicians for controlled medications may be in for a surprise. Many states have started prescription-monitoring programs, indicating details such as when and where patients have controlled medications filled. The goals of those programs are to help prevent patients from getting controlled medications from multiple providers. Rates of prescription drug abuse are quite alarming, and such abuse may now lead the country in causes of accidental death.
In addition, patients suffering with pain may be more likely to use opioid agents, which can be highly addictive and can lead to high lethality rates. With unintentional prescription overdose from opioid agents nearly quadrupling over the last decade, it is now an epidemic, outnumbering deaths from heroin and cocaine combined.
The time crunch of managed care has hit many physicians' practices hard, and doctors are more frequently prescribing pain medications to patients without providing adequate observation. Patients are also less likely to follow up with their providers because of expensive insurance co-payments, and often receive excess quantities of controlled medication through automated refills. Those addicted to prescription drugs often obtain them from a single source, and once acquired, the drugs easily spread amongst family members and peers. In fact, most patients will have obtained the medication from a friend or relative, as opposed to from a stranger or dealer. All it takes is one doctor who is not carefully monitoring his or her practice for this problem to compound.
What's even more concerning is the problem's impact on future generations. In 2010, a U.S. Substance Abuse and Mental Health Services Administration (SAMHSA) survey indicated that individuals aged 12 to 25 reported the highest rates of prescription medications for non-medical purposes than any other age group. Young people will often share the medications amongst each other in local area neighborhoods and schools. In experimenting with these medications, often young people will combine them with various other substances, with devastating effect. No one ever intends for drug experimentation to lead to an infectious disease, an accidental overdose, or actions that can lead to their best friend's funeral.
No one is discounting that those who are suffering with chronic pain should be treated any differently. Pain is real, and is problematic when untreated. Of course, patients who do require opioid agents to control their pain should continue to receive pain medications. However, while some pain sufferers may be resistant to non-opioid agents, many have not been given the chance to try alternative medications. Patients are often unaware that pain-management specialists exist, and that there are other ways to control pain.
The American College of Physicians (ACP) has recommended changes that will make it harder for prescription drugs to be abused. Patients and providers should receive appropriate education about these medications, including treatment alternatives to these agents, which may be less habit-forming and also result in improved quality of life.
The ACP has also advocated for establishing a national prescription-monitoring program, and electronic prescribing of controlled substances. While monitoring programs have already been established in certain states, having a national monitoring program would help to standardize the effort. Tighter regulations over controlled substances could help save many lives, including lives in future generations.
The views expressed are those of the author and do not necessarily reflect the views of the publisher. This version of the article was originally published on LiveScience.
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