nj.com: To reduce prescription drug abuse, start with the doctors | Editorial

Below is an editorial that ran last week on NJ.com. The information is vitally important to our communities.

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Here's a tragic reality that addicts know too well: The portal to heroin addiction is usually the family medicine cabinet.

That's where you usually find bottles of oxycodone, Percocet, and other prescription medications – opioids with highly addictive qualities – and that is how 81 percent of addictions begin.

Maybe you recognize what the starting gate looks like. The high school jock that needs a narcotic after shoulder surgery. The college woman whose only relief from migraines is hydrocodone. The middle aged man who pops Vicodin to ease his back pain.

Doctors love to prescribe pills, just ask them: A Johns Hopkins poll says 85 percent believe opioids are overused in clinical practice.

The only logical way to compel these health care providers to be more attentive to addictions – and hopefully detour the new addict from his private hell into early treatment – is by mandating such attention by law.

We hope the governor agrees. A bill that revises the New Jersey Prescription Monitoring Program (PMP) is currently on his desk, and it requires all physicians to check the database containing the patient's prescription history before a drug is administered, which would identify patients who are "doctor shopping" and spot rogue prescribers who operate pill mills.

This proposal (S-1998), part of the extraordinary 21-bill drug education and treatment package being shepherded through the legislature by Sen. Joseph Vitale (D-Middlesex), doesn't say that unfettered physicians are the problem, but do the math: Only 85 percent of physicians are registered with the state's voluntary PMP, and only 45 percent access it, creating a massive abyss for addicts and dealers to crawl into.

The bill faces opposition from some smart people, who say that forcing doctors to check the database and bring prescriptions under control would inadvertently fuel a heroin spike. It sounds counterintuitive, yet it is not without merit: When an addict's supply of $20 pills runs out, and he can't get a refill from his doctor, the alternative is to buy a $5 deck of heroin off the street.

But how much longer can we wink-and-nod at addicts gaming the system for more opioids – and give tacit approval to hoard these medications for sale and abuse – just because their doctor doesn't want to consult their pain medication records?Most addicts eventually figure out how to turn three pills a day into six, and 90 pills a month into 270.

The PMP cannot be fully effective if the current voluntary system prevails. Mandatory physician participation in the program will improve surveillance in the long run, and identifying candidates for abuse gives doctors a better chance of saving lives.

The Medical Society of New Jersey claims it is for the bill, even though it has lobbied against mandatory registration because it impinges on a physician's "professional discretion."

Some discretion: The CDC found that 259 million opioid prescriptions were written in 2012 -- enough for every American adult to have a bottle of pills -- and 46 people a day die from an overdose of that prescription pain medication.

It's time to rethink the system. Yes, the heroin factor makes it a tough needle to thread, but clearly the cycle of abuse is out of control. Too often, physicians write prescriptions because they are too lazy to register with PMP; too often, the pill mills operate in full vigor; too often, pharmacists have to make judgment calls; and too often, patients in actual need of painkillers are turned away.

It's time to start a comprehensive, compulsory database that health care professionals access with due diligence, because the present system simply is not working.

Comments

Andrea Cortese
Posted 5/6/2015 1:34 PM

Drug addiction has already claimed too many lives. A major effort must be made to change it. We teach children and teens about the dangers of drug addiction but all too often parents tell us that their doctor prescribed a 30 day supply of Vicodin for their teenager who had a wisdom tooth extraction. I think the bill is worthwhile.

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