It’s Time for Accountability
Drug overdose is the leading cause of accidental death in the US, with 52,404 lethal drug overdoses in 2015. Opioid addiction is driving this epidemic, with 20,101 overdose deaths related to prescription pain relievers that same year. And of the 20.5 million Americans who had a substance use disorder in 2015, 2 million were involving prescription pain pills and 122,000 of those were adolescents.
Today, more people die from overdoses of prescription drugs than
from illegal drugs like heroin or cocaine.
Numbers like these reveal what a dire situation we are in, and it’s about time that the doctors who overprescribe these drugs get held accountable in some way.
Three Day Dosage Limit
A recent survey by the National Safety Council revealed that about 99 percent of physicians exceed the recommended three-day dosage limit, with a quarter of them writing prescriptions for a full month and thus overprescribing these types of medications. And I have personally seen this throughout my own decade-long struggle with opiate addiction. Even when I was sober, doctors would prescribe me way too much medication – with refills! – even after I told them I had issues with addiction!
Yet, does anything happen to these doctors who exceed the recommend dosage, by a LOT? No, nothing at all. And, if there are no repercussions for these doctors, what is their incentive to change?
Thinking Opioids Were NOT Addictive
The teaching in medical school used to be that opioid medication is not addictive as long as it is given to someone in legitimate pain — something we now know not to be true. The way opioids are often prescribed, dependence can set in after just a few days, experts say. The general consensus is that:
Within one week you’ve made that person physiologically dependent on the drug, meaning they feel some discomfort or side effects when they stop using.
So to avoid feeling that discomfort, most people who take a pain pill continue taking the medication, becoming more and more dependent, as well as developing a tolerance to the drug, until they are a full blown addict.
We’re All One Injury Away From Addiction
So, let me be clear.
What started out as a legitimate prescription to pain pills, can turn into an addiction, requiring more and more of the drug to not get sick, or go through withdrawals. This is probably why opiates are recommended for short term use only, not long-term. However, since doctors often ignore this, many doctors are still overprescribing.
Then, when patients returned months, or years, later stating they were now addicted to the very drug the doctor prescribed for them, the doctor has nothing to say except,
“Well, didn’t you read the fine print on the bottle? It said it may be habit forming.”
What I want people to understand is how easy and innocent it is to get hooked, and how it could happen to anyone who went to their doctor for severe pain, maybe it was dental surgery, maybe a hip replacement. We are all just one surgery or injury away from becoming an addict. And that would be good to remember if you’re one of those people who put addicts down, or think they are “less than” in some way. It could just as easily be you or someone you love, so with this knowledge, the stigma should end.
There should be a huge warning label on those pill bottles that says WARNING: Highly addictive…Take at Your Own Risk!” Because now, instead of a pain problem, you have an addiction problem that you must battle, which is much, much worse than that original pain problem that you saw the doctor for in the first place!
What About Doctor-Prescription Culpability?
So, what happened, or is happening, to all the doctors who are doing the overprescribing, especially since it is now, very apparent, how addictive they are, no matter if you have a pain problem or not? Nothing, except for the fact that they are getting richer and richer, while we are getting sicker and sicker.
That seems fair…what??
Still, you can complain to your state’s Medical Board. Legal standards of professional conduct are set by individual state medical licensing boards and vary. While there is no single definition of “unprofessional conduct”, the Federation of State Medical Board defines prescribing drugs in excess or without legitimate reason as a serious issue. Your state’s board operates a commission that looks into complaints, and follows up with legal process.
Who’s Affected by Over-Prescription of Opioids?
Over-prescription addiction is not just happening to young people. Doctors are turning elderly people into addicts as well. At 38 million, individuals older than 65 years make up 13% of the US population, and this number is expected to increase by 7% to 10% by 2020. Furthermore, the elderly currently use one third of all medications prescribed, and data from the Substance Abuse and Mental Health Administration (SAMHSA) indicate that 2.8 million seniors abused prescription drugs in the last year. SAMHSA estimates suggest that this number is expected to reach over 4.4 million by 2020.
Additionally, the hospitalization rate due to opioid abuse has quintupled for those 65 and older in the past two decades. Almost one-third of all Medicare patients — nearly 12 million people — were prescribed opioid painkillers by their physicians in 2015. That same year, 2.7 million Americans over age 50 abused painkillers, meaning they took them for reasons, or in amounts beyond, what their doctors prescribed.
And yet doctors keep on overprescribing narcotics for long-term pain medication like it’s no big deal. Doctors tend not to be as careful scrutinizing and screening the elderly. I mean, could grandma be hooked on OxyContin? Unfortunately, yes, she could be! So, extra care should be taken.
Can We Predict Trends in Opioid Addiction?
So, how do we know who is most likely going to start abusing pain medications? We can’t know for sure, but there are some factors that could make a person be at a higher risk at become addicted to opioids:
- If you are, or have been addicted to another drug and/or alcohol.
- If a family member has addiction problems
- If you’ve gone through childhood trauma, (e.g. physical/emotional abuse, losing a parent)
- Live in an environment where prescription drug abuse is common
- If you have a mental illness (e.g. depression, anxiety), you are more likely to use pain medication long-term, and therefore become hooked
- Live in a place where there is a high availability of pain medication
Doctors and Big Pharma Payout
We are facing an epidemic, one that affects us all, young and old, mothers, fathers, grandparents and children, employees and employers, students and teachers, and loved ones, and it is time for action. With each prescription, there are payments to physicians from pharmaceutical companies. That, plus aggressive marketing and misinformation by drug companies downplaying addiction risks, while at the same time doctors are not fully explaining side effects or addiction risk, have all led to this current mess that we are in. Therefore, the pharmaceutical companies should be held accountable for their part, and doctors should be held accountable for theirs, if they are negligently overprescribing and/or ignoring the recommended dosage, causing who knows how many people to become what I call “accidental addicts.”
Let me illustrate.
Americans are in more pain than any other population around the world. At least, that’s the conclusion that can be drawn from one startling number from recent years:
Approximately 80 percent of the global opioid supply is consumed in the United States.
Yes, I said 80 percent!
Rampant use of opioids in the United States, which represents only 5 percent of the global population, points to a larger divide between affluent nations and the rest of the world when it comes to prescription painkillers. In most countries, the use of opioid prescriptions is limited to acute hospitalization and trauma, such as burns, surgery, childbirth and end-of-life care, including patients with cancer and terminal illnesses. But in the United States, every adult in America can have “a bottle of pills and then some,” U.S. Surgeon General Vivek Murthy has said publicly.
And here’s the kicker.
The 300 million pain prescriptions equal a $24 billion market. The pharmaceutical companies (and the doctors that do their bidding), are making a killing, and have the least amount of incentive to change. Could this be why they spend so much time and effort convincing doctors they were safe?
A Call to Action
Change is most likely going to have to come from somewhere else, such as advocacy groups and government organizations, or maybe those who have become addicted at some point in their lives. Perhaps these will ban together, and say,
“No! That was not ok. You had a standard level of care that was not met. It’s considered ‘Negligent.’ While I am, of course, responsible for my part in becoming addicted to the medication, you are responsible for your part as well. I think we should talk.”
Over-prescription addiction is a huge problem, and one that should not be tolerated. We now know just how addictive these opiates can be, and as a result, are not the best for long-term pain treatment, period. There is a way, right now, to help fix this opioid problem, but it’s just not being done to stop doctors from indiscriminately overprescribing, for every little thing. New guidelines need to be established and actually enforced.
Reference Sources: National Institute on Drug Abuse. (2015). Drugs of Abuse: Opioids. Bethesda, MD: National Institute on Drug Abuse. Available at http://www.drugabuse.gov/drugs-abuse/opioids
America’s Addiction to Pain Pills, John Resengren, AARP Bullentin, June 2017
‘Astounding’ Number of Opioids prescribed to Elderly, report finds, by Associated Press, June 22, 2016
Americans consume vast majority of the world’s opioids, by Dina Gusuvsky, CNBC, April 27, 2016