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Commentary: Steps to Curb Prescription Drug Abuse Epidemic

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Prescription drug abuse is more than a public health epidemic – it’s a national tragedy.

As Chairman of the House Subcommittee on Commerce, Manufacturing and Trade, I have held several nationally-televised hearings on the problem.

As Honorary Chairman of Mothers Against Prescription Drug Abuse (MAPDA), I have witnessed its pain first-hand.

And one undeniable fact stands out: Prescription drug abuse is getting worse, and a comprehensive national strategy for combating it is desperately needed.

As Americans, we rally around efforts to fight breast cancer, childhood diseases and other serious health threats. But for far too long, there have only been hushed whispers about prescription drug abuse – now the fastest growing drug problem in America, according to the Centers for Disease Control and Prevention.

So as the death toll from prescription drug overdoses continues to rise sharply, it’s time to move this story from the obituary page to the front page where it belongs.

It’s time to realize that we can’t simply wish this horrific problem away. Not with more than 20,000 people a year dying from it. Not when the number of babies born addicted to the class of drugs that includes prescription painkillers has tripled in the past decade. Not when nearly one out of 4 high school seniors has used prescription painkillers.

Rest assured, if 20,000 people died each year from food poisoning, Americans would demand immediate action.

So why has it taken so long for our governmental agencies to get serious about combating prescription drug abuse?

The Food and Drug Administration’s Risk Evaluation and Mitigation Strategy (REMS) for Extended-Release and Long-Acting Opioids is a classic example of a plodding agency muddling its way through piles of indisputable evidence.

Can anyone explain why the FDA took more than three years before deciding this month that drug companies which make “extended-release or long-acting painkillers” must provide expanded education to prescribers and consumers about the dangers and risks of addiction? How many people died needlessly in the meantime? Instead of three years, it should have taken the FDA about three minutes to take action after looking at the skyrocketing statistics and horror stories all across America.

But the FDA isn’t alone in the blame. The DEA, NIDA, SAMHSA and even Congress have all been slow to react.

So what’s the answer? I believe one critically important first step is to do a better job of monitoring and limiting access to prescription drugs containing controlled-release oxycodone hydrochloride, including the popular painkiller OxyContin.

The next step is to make certain that doctors, dentists, nurse practitioners and other prescribers are up to speed on the dangers of addiction.

Originally, OxyContin was intended to be prescribed only for severe pain as a way to help patients dealing with late-stage cancer and other severe illnesses. Today, however, more and more people across America are being prescribed OxyContin, as well as other generic oxycodone drugs, for less severe reasons – clinically known as “moderate pain” – greatly expanding the availability and potential for abuse of these powerfully-addictive narcotics.

While we’re starting to see some progress in the fight against prescription drug abuse, a lot more clearly has to be done.

By better coordinating the efforts of local, state and national agencies – and by reducing the supply of highly addictive opioid painkillers – I am convinced that we can eventually save thousands of lives, and spare millions of American families from the devastating heartache of addiction.

Rep. Mary Bono Mack, R-CA, serves as Chairman of the House Subcommittee on Commerce, Manufacturing and Trade

7 Responses to this article

  1. Avatar of allan
    allan / August 17, 2012 at 3:58 pm

    @ Rep Mack –

    if prescription drugs are such a massive problem, why not do like we did w/ tobacco and ban their advertising from TV and limit it in other media? Or does big pharma really run things?

    banning TV advertising should be easily accomplishable in a congress so adamant on stopping drug abuse, no?

  2. Avatar of Susan Klimusko
    Susan Klimusko / July 31, 2012 at 10:42 am

    What a great article. I an a nurse at a local hospital. My son went into a severe opiate addiction with Roxinols, Oxycodone, and xanax. He was 20 years old when him and his friends found a dirty doctor to overprescribe to them. Tragically, all these kids became opiate addicts and moved into heroin. This has happened across our country and now young people are dying from heroin/opiate overdoses, including my son this year. I continue to see doctors overprescribing. It took two years to close down the clinic my son went to after I reported it to the police, to the medical board and to the DA. How many more became addicted in that time?? In memory of my son and another little girl who passed weeks after him, I have started a non-profit group here in Simi Valley to try and help our community and the communities around us fix this tragedy with education and awareness. We are also supporting the families that are suffering through this nightmare and addicts that are needing the help. Not One More Overdose, Not One More lost Spirit and Not One More Grieving Heart (me) Thanks for letting me vent. Susan Not One More.net President

  3. Avatar of Natalie Costa
    Natalie Costa / July 30, 2012 at 12:51 pm

    This is a big mess on every level. The first comment seems to feel that the demand for opiates is the problem. There are people that need meds for pain. However, 227 million prescriptions for opiates were prescribed in 2010. The CDC states that we have enough opiates in this country to medicate every man and woman around the clock for 30 days. The opiates recklessly prescribed create an addiction, the addiction creates demand. The pharmacies need to report (CURES in CA) the prescriptions they fill – which will flag the dirty doctors. The opiates is one tip of the iceberg – the addict moves to heroin because they can’t afford the opiates. California virtually eliminated the DOJ which goes after these criminals (Drs. and drug dealers alike).

  4. Avatar of Rick Tennent
    Rick Tennent / July 24, 2012 at 12:54 pm

    You are so right. After being clean and sober for 12 years, my opiate addiction relapse was a direct result of 4 surgeries and need for heavy pain meds for 2 tears. I was a substance abuse therapist with an excellent reputation, I was still attending meetings, all my doctors were aware I was a recovering addict especially fond of opiate pain meds. We discussed various methods we could take to prevent a relapse…point is we took all the necessary precautions and I still relapsed on Oxy. The time release factor of Oxy was why I switched from Demerol. Clearly that did not work. My surgeon and I were planning to publish suggestions for this problem in JAMA. We never followed through because I was in full speed addiction. Well, I am clean and sober again for 4 years and back to counseling. I still have those papers and suggestions and would love to consult with others on what to do with this problem. The program I developed then is just as applicable today. I look forward to your response because I like what you are saying about this epedimic. Dr. Shore is dead on accurate about physicians needing education. One of my strategies would be to teach everyone how to spot an abuser and their cunning and creative methods used upon physiciand and pharmacies.

    Rick Tennent
    tennent1@juno.com

  5. linda holden / July 17, 2012 at 7:31 pm

    I think that is a great step giving patients information on how assicting their medicines are and the long term consequences of using such drugs. Also their needs to be a road to treatment and I agree the the drug companies should give money out of their drug sales. Some help and a starting place is better than none and staying where we are at presently.

  6. michael w. Shore, M.D. / July 17, 2012 at 1:12 pm

    Mary Bono Mack Has some thoughtful comments, but the problem demands more comprehensive solutions. The problem isn’t the prescription of opiates for chronic pain – the overwhelming majority of patients who receive these meds for pain do not abuse them. There needs to be improved education of physicians in medical school and residency on these meds, treating chronic pain and recognizing and managing addiction. There also needs to be a mandatory prescription monitoring program, similar to that which most states have independently, to allow for reviewing patient’s prescribing records and ensure no duplication of prescriptions and “doctor shopping”. Alternative approaches to treating mild to moderate pain need to be taught to physicians as well. Finially, we need to address reducing DEMAND for these opiate medications – most of these patients are reaching out for treatment to stop using them but are stymied by insurance restrictions or lack of any insurance. Michael W. Shore, M.D. Psychiatry and Addiction Medicine

  7. Steve Castleman / July 17, 2012 at 12:43 pm

    Why do the strategies Ms. Bono Mack suggest to combat prescription drug abuse concentrate solely on the supply side and ignore the demand side? Not as many would die if there was adequate treatment and not as many would become addicted if there was sufficient front-end education about why drugs are addictive and how addiction develops, and who is most susceptible to it.

    And why aren’t drug companies, which aggressively promote drugs like oxycodone, leading to billions of dollars in sales, required to use some of their profits to pay for treatment for those who become addicted to their products?

    Addiction, whether to alcohol, illegal drugs or prescription drugs, is a chronic, progressive, treatable brain disease. Polls show that the more people understand the science of substance abuse, the more they support treatment. So education is key.

    For a not-for-profit website that discusses the science of substance use and abuse in accessible English (how alcohol and drugs work in the brain; how addiction develops; why addiction is a chronic, progressive brain disease; what parts of the brain malfunction as a result of substance abuse; how that malfunction skews decision-making and motivation, resulting in addict behaviors; why some get addicted while others don’t; how treatment works; how well treatment works; why relapse is common; what family and friends can do; etc.)

    Steve Castleman
    AddictScience.com

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