MIDDLESEX COUNTY — Physicians have to be the first line of defense in stemming the epidemic of heroin and prescription drug abuse sweeping New Jersey and the nation.

That was the message given Wednesday by speakers at a symposium at Robert Wood Johnson University Hospital in New Brunswick, the fifth one sponsored statewide this year by the Partnership for a Drug-Free New Jersey.

The “Do No Harm Symposium” had speakers from law enforcement, state government, the federal Drug Enforcement Administration and leading members of the medical community in Middlesex County.

The presentations focused on the abuse of “opioids,” including painkillers like oxycodone and members of the morphine family—abuse that has been leading to a heroin epidemic.

Matthew Wilmott, staff coordinator in the Office of Diversion Pharmaceutical Investigations for the Drug Enforcement Administration (DEA), said oxycodone is going for $50 to $80 a tablet on the street while heroin is about $15 a bag.

Wilmott said kids start with pills, usually found in their parents’ medicine chest, and, when they can’t afford to buy them anymore, they switch to the cheaper heroin.

He said nationwide in 2011, there were 2.3 million people age 12 and older addicted to opiates.

Shuvendo Sen, associate program director of internal medicine residency at Raritan Bay Medical Center in Perth Amboy, said combatting the epidemic starts in the doctor’s office.

“We have been dishing out inappropriate medications,” Sen said, adding doctors have to take more time to get to know more about their patients, especially their history or family histories, and use the knowledge to decide if a prescription for prescription pain killers is appropriate.

“Physicians need to tighten loose ends,” he said. “If red flags are present, don’t give them narcotics. “

Iqbal Jafri, who helps direct the pain program at JFK Johnson Rehabilitation Institute and is a professor at Rutgers-Robert Wood Johnson Medical School, said physicians have to automatically prescribe pills to ease pain.

“There are non medicinal measures to control pain,” Jafri said. “The health care providers have to know the various treatment options. A pill is not the answer for every type of pain.”

Noel Ilogo, a physician specializing in addiction medicine at Robert Wood Johnson University Hospital, said physicians and the community need to treat addiction as a disease and treat it using a multi-disciplinary approach.

“We need programs in the community where people can go for treatment even if they don’t have insurance or money,” Ilogo said.

But doctors in the audience said many of their patients don’t have the time, money or insurance coverage to go to several different health care providers.

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Sue Epstein may be reached at sepstein@njadvancemedia.com. Follow her on Twitter @susan_epstein. Find NJ.com on Facebook.