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February 24th, 2012
12:26 PM ET

CDC director: We can reduce prescription drug overdoses

Thirty years ago, I attended medical school in New York. In the key lecture on pain management, the professor told us confidently that patients who received prescription narcotics for pain would not become addicted.

While pain management remains an essential patient right, a generation of health care professionals, patients, and families have learned the hard way how deeply misguided that assertion was. Narcotics - both illegal and legal - are dangerous drugs that can destroy lives and communities.

Millions of Americans struggle with substance abuse. Across the United States, overdoses involving opioid painkillers - a class of drugs with narcotic effects that includes hydrocodone, methadone, oxycodone - have skyrocketed in the past decade.

Today, the United States consumes most of the world’s supply of opioid painkillers. By 2010, enough opioid painkillers were prescribed to medicate every American adult around-the-clock for a month. And every year, nearly 15,000 people die from overdoses involving these drugs... more than from heroin and cocaine combined.

Studies by scientists at the Centers for Disease Control and Prevention and elsewhere show that most of these deaths are not the result of people taking small doses of opioids for a short time. Typically, problems arise when people take large amounts of painkillers or use them over a long period of time.

About 1 in 20 people in the United States age 12 or older reported using opioid painkillers for non-medical purposes in 2010. Some of these people engage in doctor shopping - getting prescriptions for commonly abused drugs from several practitioners in a short time and having the prescriptions filled at several pharmacies. In this way, people can obtain dangerous amounts of a prescription drug rapidly.

And in addition to the heavy toll this can take on lives and communities, non-medical use of prescription painkillers costs health insurers up to $72.5 billion annually in direct health care costs.

We can do more as a society to help prevent overdoses involving prescription painkillers while making sure patients who need them have access to safe, effective treatment.

Health care providers should prescribe opioid painkillers only under specific conditions, as in the treatment of chronic cancer pain when other treatments have not worked, and in limited quantities.

Providers can also screen patients for risk and history of substance abuse before prescribing opioid painkillers. Drug addiction is a disease of the brain that can be treated.

But health care providers aren’t the whole answer. Insurers and health care institutions must set up systems to identify and take action when providers or patients are using prescription drugs in dangerous ways. Some states have passed laws to rein in rogue pain clinics (“pill mills") run solely for profit, that attract drug shoppers from other states.

Individuals can help protect themselves and others by doing the following:

– Talk with your provider about alternatives to opioid painkillers.
– Use opioid painkillers only as directed by a health care provider.
– Make sure you are the only one to use your painkillers. Not selling or sharing them with others helps prevent misuse and abuse.
– Store opioid painkillers in a secure place and dispose of them properly.

To learn more about prescription painkiller overdoses, join Dr. Frieden on Twitter @DrFriedenCDC today at 2 p.m. ET


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soundoff (47 Responses)
  1. Fredward

    I I am all for a database and cracking down on misuse of this stuff. But do not take it too far. Physicians need these drugs as they are in the business of helping people, and medical access to whatever they can use is essential.

    I I am 45 and have legitimately needed these medications on 3 occasions in my 45 years. All involved surgical procedures.

    February 24, 2012 at 13:02 | Report abuse | Reply
    • Stacey

      I Would like to say just a few things about this issue.... I'am a widow with A SON and my dr. desides to send me a letter takein me out of his care>>WITH OUT A PILL COUNT OR ANYTHING TO HELP ME.... DR> CHRISTPHER DEMAS OF WESTERVILLE OHIO.... He and DR. Marvim IM of WESTERVILLE OHIO used to practice in the same office 7yrs. ago when I first became his patient. I wAS PERCRIBED PROZAC 40 MG.S A DAY, XANAX 2MG BARS 4 A DAY- XANAX FOR 7YRS WITH DRAWLS FROM THIS IF U ARE THAT IF I DONT FIND A NEW DR. NOW IN A WEEK I COULD BE IN A COMA IF MY BODY CANT TAKE THAT WITHDRAWL..BUT I GUESS IF IT WAS THEM JUST AS THE 4 PEOPLE IN THERE CARE THAT HAVE DIED in my family FROM THEM NOT CAREING ABOUT WHAT IS GOING ON AND NOT CHECKING THEM FOR PROBLUMS JUST BUTTING THEM ON MEDS. iAM ALSO PERSCRIBED YES 8 OTHER MEDS. INCLUDEING 15MG OXYCODONE. WELL I START TO GO THROW THE WITHDRAWLS FROM THE from the oxycodone witch i would not be on IF A PAIN CENTER IN OHIO WOULD TAKE ME WITH OUT INSURANCE. Now I sit and wonder whats going to happen to me i know i could die from the withdrawls alone and what i have to do to do it. Mr. dr. Demas cant help anyone step down off there meds to be safe so now i sit in my home with my son thinking will i wake up for him or not now!!!! HE "DR>DEMAS BETTER HOPE SO"

      March 13, 2012 at 23:50 | Report abuse |
  2. Cheryl

    Doctors should not be prescribing these to just anyone with pain. Opioids are being prescribed like Candy. They should be regulated and only given for certain conditions. My son passed away after being on these for 18 months. He became addicted to them. He was never told they were addicting even when he went to get taken off the medication the doctor never told him that. He was very casual about it. They DO Need to be regulated.

    February 24, 2012 at 13:43 | Report abuse | Reply
    • Neil Yaprikya

      Cheryl, what did your son die of?

      February 25, 2012 at 12:11 | Report abuse |
  3. Randy Williams

    Addicts ARE powerless by definition, so if you are taking pain meds and don't want to become powerless, do as he says and work with your MD. If you think you're in trouble for God's sake, reach out for help before the window on your free will shuts down. There will always be help, but not the will to choose it until you go to jail, the hospital, or the morgue.

    February 24, 2012 at 13:55 | Report abuse | Reply
    • Cheryl

      Randy there was no help for my son. We begged the health care (so called) addiction specialists to help him once he became addicted. the doctor who prescribed the opioids just casually said go home and take suboxone. There is more to this problem than people think. He hurt his back at work and never had a surgery he was given Lortabs 10mg/500 He should have never been given these. They made him Paranoid and Suicidal.

      February 24, 2012 at 14:19 | Report abuse |
    • Pharmaciststeve

      @Cheryl... under/untreated chronic pain can cause depression/anxiety and that can cause a person to be suicidal .. they have lost their quality of life and there could seem to be no end. He could have been paranoid about not being able to get his medication and having to deal with his pain. Back surgery is not a panacea... there are all too many people that end up in more pain after under going surgery than they had before. I did not know your son... and I am sorry for your loss... I also know that ~ 50% of the so called "drug overdoses" are chronic pain patients who are not receiving adequate treatment for their pain.. and end up spirally into depression and suicide... Our society would rather label all "death by drug" as accidental .. since you should be able to prevent a accident.. where as ... admitting that we need to treat chronic pain more aggressively by – at the very least – prescribing more opiate... would make us admit that we are allowing people to commit suicide that could have been prevented. The real stats are that < 5% of chronic pain pts will become truly addicted... but likewise 3%-5% of our population will end up abusing some substance – other than alcohol & tobacco. Most of these people have underlying mental health issues that are untreated/undiagnosed.. they are simply trying to self-medicate their demons. This is a very complicated/complex issue... and placing our focus on those that are on a self-destructive course and/or elect to "opt-out" of this life.. because they can no longer deal with their chronic pain and/or their demons... is doing a disservice to the 116 million people who suffer from chronic pain and the untold number who have mental health issues.

      February 25, 2012 at 21:02 | Report abuse |
  4. Caca

    Still a mere fraction of the death and destruction wraught by the use of acholic beverages in this country. Why aren't y'all twisted up about that? Is death by liver failure, cancer, domestic violence and drunk driving just not "sexy" anymore? Not to mention date rape, brain damage, spousal and child abuse, lost wages... and on and on and on... in MUCH greater numbers. If you're REALLY concerend about death and destruction, alcohol is what you should be going after. Cheers.

    February 24, 2012 at 14:14 | Report abuse | Reply
    • Pharmaciststeve

      They don't bother to report the 16K that die annually from GI bleeds caused by taking NSAIDs ( Aspirin, Motrin. Aleve). If you also notice that every time a "death by drug" is reported.. a LEGAL DRUG is listed first... and then "along with" ...alcohol and some ILLEGAL substances were found near the body or in their blood.. Where as.. they probably would have been just as dead without the legal drugs.

      February 25, 2012 at 21:05 | Report abuse |
  5. Taylor

    Opiod pain medictions ARE regulated. In fact, Fla aside, prescription narcotics are much more difficult to legally obtain than recent news articles suggest. The problem is not the RX, it is the patient. As a pain patient, it is up to me to use my RX wisely. It is MY responsibility to take as directed, to avoid alchohol, to notify my doctor if the dosage no longer works, etc. Addiction does not happen over night. Addiction and accidental overdose happen when a person abdicates responsibility for their health and well-being. Start teaching people personal accountability and you won't need legislation to control the problem.

    February 24, 2012 at 14:29 | Report abuse | Reply
    • Cheryl

      Sorry to disagree Taylor but my son used his pain meds as directed by his Doctor and became addicted within a short time. .He was prescribed a high dose and told to take them and he did. He trusted the doctors "judgement". When he asked him for help he did not get it so please dont tell me about these pain medications. They are prescribed like CANDY and my son has died because of them. Maybe you should check out what you are taking because you are probably addicted and you dont know it.

      February 24, 2012 at 14:52 | Report abuse |
    • Pharmaciststeve

      @Cheryl... your son may have been DEPENDENT.. and the doc decided to stop prescribing the opiates for his back pain... for no reason... or the amount of medication was less than his condition really required to help him maintain some sort of normalcy. Pain is SUBJECTIVE .. no one knows how intense a person's pain is .. except themselves... and the intensity of their pain will vary minute to minute... hour to hour .. day to day .. Diabetics are DEPENDENT on injecting insulin... they are "shooting up" all the time.. everyone is DEPENDENT on AIR/Water/sleep/food... everyone needs for these varies minute to minute.. hour to hour... day to day... A chronic pain patient "needs/wants" their quality of life back... sometimes .. the only way that is going to happen or get close to happening is via on going opiate therapy. Come on... tell the whole story about your son path dealing with chronic pain.. not just the unfortunate outcome... that has made you so biased.

      February 25, 2012 at 21:21 | Report abuse |
    • Brian

      Pharmaciststeve, I hear you, and I know you have concern and compassion for pain sufferers, and that's why you recommend opiate therapy. But I have to ask a question: did it used to be this way 50-60 years ago? It just seems that more and more people (two in my workplace alone) are complaining of pain and needing increasingly aggressive pain med regimens, and I find myself wondering why, when it didn't seem to be that way years ago (I'm 49). My elderly father once made a remark to that effect as well.

      I had serious back pain for over a dozen years - I had injections, physical therapy and exercises, and nothing totally eliminated it. Then a friend tells me to try T'ai Chi and I've now been pain-free now for five years! Another friend tells me her Yoga ended her back pain. I don't understand why they should work, but they apparently can. So I ask you, how can something so simple (and cheap) work??

      I have enormous respect for the medical community but due to my experiences, it's impossible for me to not wonder if somehow the medical community is missing a piece of the puzzle when it comes to its approach to some of these pain conditions.

      January 25, 2013 at 00:49 | Report abuse |
  6. Taylor

    @Cheryl, sorry for your loss. While I wouldn't presume to know the details of your son's situation, I do know that work injuries are covered under Worker's Comp and the worker is free to change doctors any time. If your son felt that his treatment was subpar it was his responsibility to find another doctor.

    February 24, 2012 at 14:49 | Report abuse | Reply
    • Cheryl

      And now we find out in New York State that he shouldnt have been on them for more than 2 months. How do you know if the doctors treatment was "subpar". Are you kidding me. He died from these and we have thousands of people being prescsribed these opioids and are dying everyday. Sorry for my loss Really! I have met many families where the same thing happened You have no idea what you are talking about. Didnt you listen today to Dr. Reef Karim He knows about this epidemic.

      February 24, 2012 at 14:58 | Report abuse |
    • Bubba™

      @ cheryl..... your view is obviously not objective. You have an ax to grind. Don't blame Rx drugs for abuse any more then you would blame Ford or GM for drunk driving. Wake up already and blame the abuser. Just like with guns, "blame the finger, not the trigger"

      February 24, 2012 at 21:52 | Report abuse |
    • Bubba™

      Guns don't shoot themselves, and Rx drugs don't abuse themselves either.

      February 24, 2012 at 22:00 | Report abuse |
  7. Taylor

    Actually, Cheryl, I have done extensive research on the subject. And no, I am not addicted. I am merely suggesting that, at the first hint of trouble, that a patient needs to take aggressive control of their situation.

    February 24, 2012 at 15:00 | Report abuse | Reply
  8. Taylor

    @ Cheryl, try reading peoples comments before you go off on them.

    February 24, 2012 at 15:09 | Report abuse | Reply
  9. Fredward

    Taylor is correct, most physicians and practices want to avoid problems and are careful about this. There are always exceptions. I am in favor of tight controls but do not want to see physician's hands tied on how they can treat their patients. And if the pendulum swings too far that is what is going to happen and people will needlessly suffer.

    February 24, 2012 at 15:24 | Report abuse | Reply
  10. david

    Dr Frieden- who was head of health care in NYC- which had the worst pain care in the Nation in 2007- has a poor record in helping people with chronic pain- he neither has an inspiring plan or vision to lower the prevalence of any painful condition. He clearly doesnt believe in primary prevention for painful conditions nor in requiring doctors to have education in pain care. As you see in this article Dr Frieden makes no mention of making use of safer more effective interventions for people in pain. He is obviously someone who has no sympathy for people in chronic pain- i challenge him to a debate in public on the issues- but like most doctors he was trained to be innured to the issue of pain -and knows very little about painful conditionsAs Einstein wrote – you cant solve a problem with the same consciousness that created it- Dr Frieden is part of the failed consciousness that lead to the ever rising epidemeic of chronic pain in theis Nation- he and the CDC continue to fiddle while people in pain continue to burn

    February 24, 2012 at 15:58 | Report abuse | Reply
  11. Bubba™

    Like alcohol, tabacco or any drug the key word is abuse not use. Taken in therapeutic doses the Rx should not pose a problem, simple blood tests could identify abnormal levels of these drugs. People who actually benefit from such drugs should not have to suffer.

    February 24, 2012 at 21:37 | Report abuse | Reply
  12. Kate Johnson

    While I have no doubt that there are significant abuses, Dr Friedan clearly has no compassion whatsoever for chronic pain sufferers or those with cancer. He offers no alternatives, but basically "suck it up you cancer patients, we don't want you to become addicted to pain meds while you die, we'd much rather watch you writhe in pain and suffer as much as possible. There are many areas that would seem to be better candidates for restricting the use of opiods than people with cancer..

    It's sad, because this article will do little to change abuses, but I imagine it will terrorize oncologists into making their patients endure unreasonable and unnecessary suffering.

    Another way to reduce opiod overdose is to legalize medical marijuana. It is impossible to overdose on and while it can be psychologically addictive, it is not physically addictive. There's really no excuse for it not to be legal for medical use, except for the fact that big pharm can't cash in on it.

    February 25, 2012 at 02:26 | Report abuse | Reply
    • david

      Dr Frieden and his coleagues- Dr Collins and Dr Tabak- and the pain consortiu have no vision nor plan to lower the prevalence of any painful condition-they perceive people in pain as a burden to society and in the last decades the prevalence of painful conditions-many caused by doctors has risen-and is expected to rise. The American public deserves public officials who will work for the good of the publice- Dr Frieden certainly doesnt recognize the needs of the public- hes too focused on serving his comrades in medicine

      February 25, 2012 at 11:18 | Report abuse |
  13. Taylor

    The fatal overdoses follow the increase in prescriptions quite closely, suggesting that while the absolute number of incidents is higher, the percentage of RX that result in fatal OD has remained the same.

    February 25, 2012 at 02:30 | Report abuse | Reply
  14. marlies

    Wow. I have read through these posts and as an RN know first hand how touchy this subject is. Yes, patients deserve proper pain control and we are taught that the Patient is the only expert on their pain. Only they know what they are truelly feeling.

    That being said ... myself and other RN's I work with often feel like we are the narcotic store. Cannot tell you how many times we have people admitted for "abdominal pain". Extremely generalized and such a hit / miss diagnosis. The narcs they are started on is rediculous. And most expect – demand – us to be in there every two hours or so with their morphine, dilaudid, AND OR pain pills – often times we feel the doc's "give in" because they are too worried of being attacked and have patients give them bad reports.

    Pain pills – can be addicting. And not everyone is self aware enough to know when or what to avoid. Also, as Cheryl said most people trust their doctor (typically I find those are the patients who rarely go to a doctor unless something major happened such as being hurt at work or needing surgery.)

    I myself have had narcs prescribed to me for dental pain ... I learned quickly that my body does not tolerate Lortab (could FEEL myself getting addicted and I only took a few doses over a very short amount of time.) Percocet – makes me so nauseated it's not worth it to me to take it round the clock for any pain. Also I noticed the few times I have been prescribed pain pills the amount of pills would only last a person two days at the most if taking two pills every 4 hrs as most RX's are for.

    It is everyone's responsibility. Physicians – there should be a thorough history taken (not fool proof as people do lie, hide, and cover up stuff or convienently omit pertinent information). Nurses – EDUCATION! I have not ever started a patient on a med nor have I sent them home with a prescription without giving printed education as well as verbal. Someone mentioned liver disease and such – as a nurse it is a responsibility of mine to make sure patients are aware narcotics can cause such diseases. Both Lortab and Percocet have tylenol in them – if you take straight tylenol on top of a percocet or lortab you are increasing the chance of overdoseing on tylenol -> liver damage! Not to mention kidney damage as most drugs are processed out of your body via kidneys or liver. Alcohol is not the only thing that damages these vital organs.

    Pharmacists – also .. EDUCATION. And they should be linked to create a database – which I believe most are because I have seen the printouts which prove when and where patients have had RX's filled. Patients records should be flagged if multiple narc RX's are on their profile. And perhaps a different approach needs to be explored. People do have chronic pain – but there are so many other options our there aside from narc's. Anti-inflammatories .. relaxation techniques, etc.

    There is no easy answer to this. In my opinion healthcare has become so ruled by politics and such that healthcare workers are slammed with the pressure of making a profit and keeping money coming in that standing up against it is hard.
    As an RN I have experienced this first hand. If I do not JUMP each and every time a patient tells me the morpine, and pain pills aren't working .. they need more .. I am written up for not being a patient advocate and addressing my patients pain needs. Heaven forbid a patient complains and says we ignored their pain .. and yet at the same time shame on us if we do not stand up and say no more when the patient is so out of it their speech is slurred and they cannot complete a sentence.

    February 25, 2012 at 12:32 | Report abuse | Reply
    • Pharmaciststeve

      Those databases that you refer to PMP (Prescription Monitoring Programs) are on-going in 35+ states.. and few are inter-connected. President Bush signed a law for a national database (NASPER) in 2004 and Congress has yet to fund it. In fact.. from a Pharmacist perspective... the transmission of data from the prescription filling process is both transparent and mandatory.. yet .. for us to retrieve a report... is laborious and time consuming....in fact, some of the larger chain stores prohibit their Rx dept access to the internet.. which is the only way that a report can be generated.
      Also – to the best of my knowledge – no state allows any healthcare professional to validate a driver's license against the state's BMV's database.. we have to accept the license presented to us at face value and report it to the PMP. Fake ID's are rampant... so even if a healthcare professional does a PMP report... the PMP database can be corrupt with fake id's... so really what go is it to run the report?
      What healthcare professional would prescribe/dispense a control substances to a person who can't produce a verifiable ID...yet the bureaucrats prevent healthcare professionals this one small methodology of helping to keep prescription drugs from being diverted.
      If docs would stop treating chronic pain .. like it is acute... and stop under treating it... there would be a lot less demanding for the next dose of opiates. I have converted a few docs and ARNP's into believers and patients have a better quality of life... if it more common sense than rocket science...

      February 25, 2012 at 21:44 | Report abuse |
    • Cheryl

      Thank You Marlies We truly need more people like yourself in the Health Care System. Thank You

      March 3, 2012 at 22:54 | Report abuse |
  15. Taylor

    @marlies, I agree that addicts will say and do anything for a dose. But there are times when an in-hospital patient does know best. I had extensive abdominal surgery for cancer several years ago. When I was xfer'd to my room from OR recovery I was given a PCA device and told to 'push the button'. Unfortunately, the device did not work. It took 3 hrs to get someone to actually look at the devise and swap it out. Lucky 4 me my partner was there – I was unable to talk. The staff was so worried abt a morphine od they missed the forest for the trees. It's fortunate for them that I did not die of shock that day.

    February 25, 2012 at 13:31 | Report abuse | Reply
  16. Taylor

    On a lighter note, I think the key is to find a way to better identify that very small percentage of patients that are likely to misuse their RX and adjust prescribing practise accordingly.

    February 25, 2012 at 13:40 | Report abuse | Reply
  17. r

    How about reducing the PRICES of prescription drugs for the majority of people who do not abuse meds?

    February 25, 2012 at 15:59 | Report abuse | Reply
  18. Annaliesa

    Sticky issue.

    In my neck of the woods, it's very difficult to get opioid pain medication unless you've recently had surgery. I've done work in social services, and we had clients who have had struggles to get pain medication. On the plus side, we're a medical marijuana state, which has opened up an option for individuals with chronic pain. I'm definitely not one of those "Pot will save the world" folks, but it is fairly nontoxic. The memory issues aren't great, but it does beat significant pain.

    Most states have a system for pharmacists and doctors to keep tabs on where people are filling their prescriptions. We had run reports on people we suspected of abusing prescription drugs. Some where filling prescriptions at multiple pharmacies, and some weren't.

    A lot of chronic pain patients are responsible with their medication. Often they have more issues with dependence than abuse, and medications containing NSAIDS cause more issues than medications without – by this I mean they cause organ damage if used in high dosages. And the overdose from opiates with NSAIDS combined is quite a bit nastier than an opiate alone. Yet, combining the two classes of medication can allow less of an opiate to be used. On the other hand, the risk of organ damage (often liver) is significant enough that the FDA is recommending that acetaminophen dosages be reduced in Vicodin, Norco, etc.

    For me, I cannot take NSAIDS except for aspirin and acetaminophen without strict lithium level monitoring. Steroid use would also need to be strictly monitored because of risk of mania. Tramadol could cause Serotonin Syndrome since I am taking an antidepressant, and abuse has actually been reported – it was originally toted as a nonaddictive alternative to opiates. For me, opiates are easier if I need some short-term pain relief. However, it was not easy for me to get a short course of Vicodin when I threw my back out recently. Bipolar Disorder seems to scream "Addict!" to a lot of doctors. I don't drink, I don't smoke, and I have never been addicted to anything more than caffeine. After a bit of whining, I was prescribed Norco and physical therapy – it was hard to get that, too. As it turns out, opiates give me insomnia and lack of sleep just makes me crabby, so I've only taken a few – when I felt really horrible. I didn't find the "high" appealing – feeling dopey just isn't for me.

    Physical therapy, which is pricey and sometimes not covered by insurance, has been helpful. I did meet a few people when I was working who didn't have the option, which is another problem. Massage, which is also expensive, can be very helpful for pain but insurance often doesn't cover that, either.

    I recently read that pain is actually significantly under-managed in general. A lot of the people abusing pain medication are people who don't have chronic pain and are stealing or buying pain medication off of the street. I imagine this varies by area, of course. As others have mentioned, pain medication is prescribed in high volume in their areas.

    This is a difficult problem and needs to be addressed. Non-medication options need to be available to everyone at an affordable cost, and more research needs to be done on the relationship between pain, pain medications, and the brain.

    February 25, 2012 at 19:44 | Report abuse | Reply
  19. Taylor

    @pharmsteve, good input. The other statistic that is noticibly absent from this dialogue – the number and percentage of fatal OD where patient exceeded the prescribed dosage, and/or ingested alcohol or other drugs. Let's be honest, most of the deaths were not mysterious, they were the predictable outcome of typical addict behavior.

    February 25, 2012 at 21:58 | Report abuse | Reply
  20. Taylor

    Just read @pharmsteve's last comment. I agree completely regarding aggressive pain management. Better pain management does not create addiction, and dependance is not the same as addiction. Addict behavior is very specific, repetative and predictable, and is not analogous to that of pain patient.

    February 25, 2012 at 22:11 | Report abuse | Reply
  21. Taylor

    Also agree with @pharmsteve that many people would rather opt-out than continue to live with severe, unrelenting, under-treated pain.

    February 25, 2012 at 22:27 | Report abuse | Reply
  22. THINK BEFORE YOU SPEAK

    we cant even trust the simplest deed to be taken care of or watch our brothers back! I CERTAINLY DO NOT TRUST THE IDEA HERE ABOUT PRESCRIPTION OVERDOSE BUT IF WE CLANP DOWN ON THE PEOPLE IN CHARGE & WE KNOW OCCUPY WALL STREET WHO THESE PEOPLE ARE WE THE AMERICAN PEOPLE CAN GET BACK TO BUSINESS AS USUAL! BY ALL MEANS SECURE AMERICAS BOARDERS LAND & AIR NOWWWWW!

    February 26, 2012 at 14:33 | Report abuse | Reply
  23. Cobie

    Maybe instead of prescribing people a synthetic killer like opiods, we should move on to a natural non addictive healthy pain killer, I'm talking about cannabis a plant which not only is a great pain killer it's an anti depressant and helps fight cancer, impossible to over dose on and non addictive. Almost sounds to good to be true huh? The government is keeping patients from safe medication and its awful

    February 26, 2012 at 22:41 | Report abuse | Reply
  24. H H

    Patients, not addicts, are punished by laws like these. Far too many doctors want to give suffering patients dinky drugs like ibuprofen for serious injuries! They think it's okay for you to hurt "a little bit" rather than become addicted. They, of course, can't feel what you do, so pain is just fine in their book. Pain is not normal, and there is no reason for a patient to suffer needlessly, or tax an already burdened body, by refusing to provide them with adequate pain relief. "Bite the bullet" ended with the Civil War – and should have! Pain is in fact a counter to narcotic addiction. It's the people who take it just to take it that end up with problems.

    February 27, 2012 at 08:34 | Report abuse | Reply
  25. EDMD

    As an ED MD I will tell you we prescribe narcotics because the system allows for the patient, drug seeker, etc to give us poor evaluations which could result in our dismissal. Our answer is to just give the narcotics so we con't to have a job. We must address the over inflated evaluation process for physicians from their patients. Yes we need feedback but this is directly related to why ED's across this country are prescribing narcotics at an alarming rate. Sometimes its a physicians job to tell a patient they do not need a certain type of medication such as a narcotic but when that same person can say "he/she was a horrible doctor because he didn't give me my dilaudid" then that is a problem.

    February 27, 2012 at 11:02 | Report abuse | Reply
  26. alec

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    February 27, 2012 at 13:09 | Report abuse | Reply
  27. Ashley Behrle

    Reblogged this on ASAP's Policy and News Blog and commented:
    Another interesting article on the problem of prescription drug abuse

    February 27, 2012 at 13:11 | Report abuse | Reply
  28. HH

    I knew people who ended their lives because of chronic pain. They didn't get adequate relief, and it was too much. One of these people was sent to "pain 'management' therapy" that was nothing but SPIN. It was supposed to teach her "behavior modification" that amounted to "don't focus on your pain, suck it up, and if you'll be fine if you just ignore it." It was absurd and completely cruel to a gifted, intelligent individual.

    Another thing about overdoses, and people who obtain painkilling drugs illegally – often it's because their own physicians refuse to give them relief. They seek out what they can get illegally in a desperate bid for deliverance from their suffering....with tragic consequences.

    Stop punishing people. Start treating them.

    February 27, 2012 at 14:18 | Report abuse | Reply
  29. KK

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    March 1, 2012 at 23:26 | Report abuse | Reply
  30. Romina

    I agree that the abuse of opiod pain killers is an epidemic that needs to be addressed; however, we need to avoid blaming the patient for this epidemic as this is a symptom that chronic pain is not being properly addressed by our health care system. I recently read a MMWR released by CDC where patients abusing these drugs were overtly blamed for this epidemic. We need to blame the current system, which focuses on treatment rather than on prevention of chronic illnesses. The current model is outdated and something needs to be done if we want to fix it. People are abusing pain killers because they are suffering. Many people can't afford alternative therapies or cognitive-behavioral therapy to treat conditions like fibromyalgia an use opiod pain killers because that is the only choice they have. We need to educate the public about effective treatments for chronic pain while avoiding blaming the patients themselves. If our system doesnt shift to a focus on prevention, this issue will not be solved. As a fibromyalgia sufferer myself who is fortunate enough to afford various treatments for my condition, what I can say is that the only answer mainstream physicians have for people like me is drugs. I recently asked my reumathologist about a behvioral or physical therapy and if he knew of a pain counselor. He didnt have an answer for me and honestly didnt care. I asked this doctor for specific help to avoid falling in the traip of pain killers, but all he wanted to give me was more drugs. I'm an educated patient and researcher myself, how do you expect the average person to cope with this disease when there are no referal mechanisms in place for a comprehensive approach?

    March 8, 2012 at 10:48 | Report abuse | Reply
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  33. bolo415

    Physicians such as Dr. Frieden, Andrew Kolodny, and others seem to want to roll the clock backward to a time when severe, non-malignant pain was more or less ignored by physicians who received no training in managing it, and the only people allowed the medications that are still (unfortunately) the gold standard of pain relief were the dying. They point out known issues with long-term use of opiate/opioid medications, but don't seem to have any particular answers for those patients for whom nothing else has ever been effective. (Other than, apparently, "suck it up".)
    I have a chronic, non-malignant pain condition (daily severe migraines) which physically, as far as we know, won't do me the slightest harm. Unfortunately, the pain is so intense that, untreated by narcotics, death is preferable. If you believe that statement simply indicates that I'm just not tough or strong-willed enough, you're simply a fool who: 1. has no idea of the degree of severe pain I am able to tolerate without the slightest complaint. 2. has never experienced genuine level 9 or 10 pain for months and years on end. These doctors don't seem to grasp the notion that you don't have to have a disease that's killing you to be in intolerable agony. Nor do they acknowledge the fact that many diseases aren't at all understood, so a "cure" is not yet possible. Does long-term opioid therapy give you chronic dry mouth and problems with tooth decay? Yes. Virtually every tooth in my head is filled. Does it affect your endocrine system? Yes. Without supplements I have the testosterone level of a ten-year-old girl. Am I drug-dependent? Yes. (And if you don't know the difference between dependence and addiction, learn it before you open your mouth on the subject.) It's not fun in the slightest. But where are your other options? Was I prescribed opioids immediately? Absolutely not. I've taken tryptans, beta-blockers, calcium channel blockers, anti-seizure meds, Botox, and basically every other drug that someone once said helped them with migraines. I've had acupuncture, nerve blocks, acupressure, rational-emotive therapy, and some guy gluing silver beads to the inside of one ear. I've been "detoxed" from opioids, hospitalized, and put on some combination of meds that was supposed to help migraines, but basically just made me wet the bed, grind my teeth in agony, and start trying to figure out how to get the hospital bed to crush my skull. Until someone either comes up with a non-opioid (and legal) painkiller that works as well, or discovers all mechanisms behind migraines and a way to cure them, this life and this treatment is the BEST THAT I CAN DO. Yes, patients who take opioids long term need careful screening and continuous monitoring. They're also going to need treatment for unavoidable side-effects, including therapy to learn how to manage the remaining pain that no reasonable drug dose can address, and how to avoid falling into the major depression that long-term pain inevitably causes.
    Physicians such as Frieden, Kolodny, and those like them seem to want to simply ignore me and thousands of other patients in similar situations. This is not the life we wanted. These are not drugs we wished to take. These are not side-effects we wanted to deal with. Perhaps these doctors' time could be better spent finding ways to help people with truly unbearable non-malignant pain, instead of publicly railing against the only treatment available now that gives us even a marginal quality of life, contributing to the chilling effect that is still leaving many thousands in under-treated misery.

    July 2, 2013 at 22:36 | Report abuse | Reply

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