Saturday, Jul 21, 2018
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Killing pain

Prescription drugs ease pain for millions of Americans, but also inflict the agony of addiction on millions more

Prescription drug abuse has become, over the past decade, an escalating epidemic across the country — and especially in Ohio. Our state has the nation’s 12th highest drug overdose mortality rate, with 16.1 people per 100,000 dying of overdoses, according to a new report by the nonprofit Trust for America’s Health.

Since 1999, U.S. sales of prescription painkillers have quadrupled. Prescription drug abuse now accounts for more deaths than heroin and cocaine combined. In 2011, 1,765 people in Ohio died from drug overdoses; opiates were responsible for most of them.

Prescription painkillers affect the same pain receptors in the brain as heroin does. In Ohio, as in other states, satisfying a serious opiate addiction with heroin has become cheaper than buying painkilling pills on the street.

Still, a new recommendation by the U.S. Food and Drug Administration that would tighten controls on how doctors prescribe commonly used narcotic painkillers may not be the right prescription. Such restrictions should not become law until the government knows more about how they would affect the tens of millions of people who receive Vicodin and similar prescriptions for legitimate reasons.

Most life-threatening emergency-room visits related to use of prescription painkillers are caused by powerful drugs such as OxyContin, which is a tightly restricted Schedule II drug. Putting similar restrictions on drugs with less potential for abuse such as Vicodin — now classified as Schedule III — could cause hardship for the nearly 50 million patients a year who use them.

Nor have tighter Schedule II restrictions stopped the growing epidemic of OxyContin abuse. Interdiction is simply not the most effective way to reduce drug abuse of any kind. Educating prescribers and the public, issuing voluntary guidelines, and expanding treatment yield better long-term results.

Ohio, under Gov. John Kasich, has such a multipronged strategy. The Governor’s Cabinet Opiate Action Team recently released guidelines for prescribers, including recommendations on maximum daily doses for opiate painkillers.

At the same time, it has issued new guidelines for emergency room doctors. In the second quarter of 2013, prescribing of painkilling pills in Ohio dropped more than 6 percent.

The administration has also expanded the range of treatment options for opiate addiction in clinics — which formerly relied on methadone — to include effective new drugs such as suboxone.

“Drug abuse has been a priority of this administration,’’ Eric Wandersleben of the Ohio Department of Mental Health and Addiction Services, said. “We know we’re not going to arrest our way out of this problem.”

Ohio also runs prescription drug monitoring programs, which help pharmacists and doctors identify patients who are doctor-shopping — visiting various doctors to fill more prescriptions. The state scored well on a prescription drug abuse report card issued by the Trust for America’s Health.

Even so, Ohio needs to do more about prevention and public information. Many Ohioans are not aware of the health hazards that prescriptions drugs can pose when they are used improperly.

People take pills prescribed for friends or family members, or buy them on the street from patients who had legitimate prescriptions. Drug houses that sell a range of street drugs now also peddle prescription drugs.

In Utah, a “use only as directed” media and education campaign promotes the safe use, storage, and disposal of prescription drugs. In Portsmouth, Ohio, mothers of dead addicts talk to schoolchildren about prescription drug abuse.

Perhaps the most effective public service efforts on drug abuse use local people, recognizable to many in the community, who have been directly affected by drugs. Ohio should offer more of them.

Prescription painkillers have eased an enormous amount of pain for millions of Americans, but they have also inflicted the agony of addiction on millions more. Greater awareness about their dangers and treatment of addiction — not inflexible restrictions on patients — must become even higher priorities for Ohio.

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