NJ.com: Requiring doctors to check prescription database could help stem N.J.'s opiate epidemic | Opinion

2/24/2015

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A pharmacist fills a prescription at Panther Valley Pharmacy in Allamuchy in this 2013 file photo. A bill in the state Senate would require all doctors to consult a database before prescribing opiates to determine if those patients have received the same prescription elsewhere. (Robert Sciarrino/The Star-Ledger)
Star-Ledger Guest ColumnistBy Star-Ledger Guest Columnist 
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on February 24, 2015 at 7:30 PM, updated February 24, 2015 at 7:32 PM
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By Elaine and Steve Pozycki

Gov. Chris Christie's use of the bully pulpit to shine a light on the epidemic of opiate addiction in our state has begun to generate a long overdue public conversation about the most effective ways to solve the problem. Certainly, expanding access to treatment as the Governor proposes is a key component of any comprehensive solution. 

Treatment, however, remains a hit-or-miss proposition. Unfortunately, the results as of now do not yield a high success rate. Because of brain changes caused by opiate addiction, the road to recovery is hard, difficult and sometimes impassable.

Because of brain changes caused by opiate addiction, the road to recovery is hard, difficult and sometimes impassable.
 

While it remains vital to fund expanded treatment, stemming opiate addiction also requires a stepped-up emphasis on prevention. 

That means attacking the problem at its source; namely, the over-prescribing of opiate-based prescription drugs. The Centers for Disease Control and Prevention (CDC) has reported a threefold increase in the number of prescriptions issued for opiate-based painkillers, such as Vicodin and Oxycodone, during the past 20 years. Health care providers wrote 259 million prescriptions in 2012 and one in four teens report abusing a prescription drug. As Dr. Tom Frieden, CDC director, said, "The bottom line is we're not seeing consistent, effective, appropriate prescribing of painkillers across the nation, and this is a problem because of the deaths that result."

While the Medical Society of New Jersey claims this that these practices are changing, they sure aren't changing fast enough to prevent more ruined lives and avoidable deaths. Even physicians themselves overwhelmingly agree that opiates are still being over-prescribed. In a recent national poll conducted by the Johns Hopkins School of Public Health, 85 percent of doctors say opiate-based painkillers are over-used. Forty-six people die daily in this nation from prescription drug overdoses.

Prescription painkillers also provide a gateway to heroin addiction. Heroin is opiate-based, and as a result works on the same brain receptors. When some addicts can no longer get access to prescription painkillers they turn to heroin.

We simply must put in place common-sense policies aimed at prevention. We're pleased to report that there are now two such measures.

State Sens. Loretta Weinberg ( D-37th Dist.) and Joe Vitale (D-19th Dist.) have put forward two proposals arming patients and doctors with the information required to prevent opiate addiction. The first bill (S2366) provides adult patients and parents of younger patients with critical information needed to make an informed decision about whether to take an opiate-based prescription pain-killer or use a nonaddictive alternative. Requiring that prescribers supply these facts ensures medical consumers can make an informed decision.

The second bill (S1998) gives the state's Prescription Drug Monitoring Program (PMP) teeth by requiring all doctors to participate. The current voluntary approach has not been able to attract sufficient participation for real effectiveness. This legislation ensures that doctors check a state database to identify patients that are doctor-shopping to feed their addiction.

The patient notification legislation recently passed the state Senate 36-to-1. We are expecting a similar result on the PMP proposal. 

While many doctors support these important proposals, The Medical Society of New Jersey is opposed, making this a potentially tough fight in the Assembly. Our disappointment in their position is compounded by their attempt to sow confusion with misleading arguments.

For example, The Medical Society asserts they support a mandatory approach to the Prescription Drug Monitoring Program. They do back some requirements. But the key to successful monitoring is requiring all doctors to check the prescription database before issuing an opiate prescription. They oppose this provision, claiming it impinges on their 'professional discretion."

For those too many of us who have lost family members to prescription drug addiction, this rings hollow. Prescribers' unfettered discretion is what caused the problem in the first place. Further, a national evaluation found that strong PMPs are associated with lower rates of treatment admissions.

These two bills will equip New Jersey families and the medical community with the tools to prevent addiction. It's time for all of us to put public health first. 

Elaine and Steve Pozycki are board members of the Partnership for a Drug-Free New Jersey. Elaine Pozycki is the partnership's co-chair. Steve Pozcyki is the founder, chairman and CEO of SJP Properties.