Lawmakers in the state of Washington are using aggressive measures to stem the tide of prescription drug abuse. A new regulation requires doctors to refer patients who are taking high levels of prescription painkillers to a pain specialist if their condition shows no signs of improvement. The painkillers that the regulation pertains to include hydrocodone, methadone, fentanyl and oxycodone (the active ingredient in OxyContin). All of these drugs, which are classified as opioids, are subject to abuse, dependence and addiction.
Opioid painkillers are currently the most widely prescribed category of drugs in the U.S. Over the past decade, doctors have increase the number of prescriptions for these drugs by more than 400% despite limited evidence of their effectiveness in treating chronic pain versus the risk of dependence and overdose.
The Centers for Disease Control and Prevention has urged doctors to lower the levels of opioids being prescribed. Over-prescription has led to the drugs being easy to obtain on the street and contributed to the rising epidemic of opioid addiction and the number of overdose deaths. According to The New York Times, many drug abuse experts believe that doctors are grossly overprescribing these drugs. Patients who are prescribed the drugs for years develop a psychological dependence that can be compared to addiction.
It has only been in the past 15 years that powerful painkillers have been used to treat chronic pain. Previously they were only used for short-term pain management following surgery or terminal conditions. According to Dr. Jane Ballantyne, a Seattle pain expert, doctors initially embraced painkillers because they wanted to help people in pain. Many patients are now paying the price. “The long-term outcomes for many of these patients are appalling, and it is ending up destroying their lives.”
A Washington state official named Dr. Gary Franklin initially sounded the alarm about prescription painkillers in 2006 when workers’ compensation data revealed that the number of patients taking opioids in large quantities had increased by 50 percent in just a few years. Because patients tend to develop a tolerance for opioids as time passes, doctors were prescribing the drugs in greater amounts rather than helping wean patients off the drugs. Instead of focusing on the underlying condition, many doctors found it easier to continue to treat pain with increasingly larger doses of drugs.
As the new law moved through the Washington legislature, the manufacturer of OxyContin unsuccessfully tried to block it. Several national pain experts also lobbied against the law, claiming that patients would be restricted from receiving proper care under the new regulation. The New York Times reports that some of these experts have ties to the drug industry.
Dr. Ballantyne, who is one of the pain specialists who now sees patients who are taking high doses of opioids on a daily basis, would like to see a return to nondrug treatments like counseling and physical therapy for the treatment of chronic pain. “If doctors understood how hard it is to get patients off these drugs, they would not prescribe them to begin with.”