Are Doctors to Blame for the Prescription Drug Addiction Crisis?
Every year, U.S. doctors prescribe more opiate painkillers and other prescription medications than any other country in the world, by far. In fact, eight out of 10 prescription painkillers made worldwide are consumed by Americans. As the prescription drug addiction epidemic has continued to spiral out of control, many are pointing fingers at doctors. A more thorough look at the problem, however, shows that doctors are only a part of the problem, and are even caught in a no-win scenario when it comes to curbing addiction and managing their patients’ pain.
Prescription Drug Statistics
- Americans consume 80 percent of all opiate painkillers manufactured in the world
- According to the Centers for Disease Control (CDC), enough painkillers were prescribed in 2010 to “medicate every American adult around the clock for one month”
- More than 4 billion prescriptions were written in the U.S. in 2011—roughly 13 prescriptions for every American
- 16,500 Americans died from prescription painkillers in 2011
- The number of annual prescription painkiller overdose deaths in the U.S. have increased 500 percent since 1990
History of the Painkiller Crisis
It wasn’t that long ago when doctors were blamed for prescribing too few opiate painkillers, leaving their patients in pain. As recently as the 1980s, the medical community struggled with widespread oligoanalgesia, meaning the “under-treatment of pain.” Studies of the healthcare system revealed large discrepancies in how pain was identified and treated, leaving many patients with inadequate pain relief.
As a result of these findings, the U.S. medical community initiated a movement to help doctors identify pain more consistently, and to encourage more liberal use of painkillers, particularly opiate painkillers. Many of the resulting changes were brought about by several large opiate drug companies that all stood to gain sales if the changes were implemented. These same drug companies have also been accused of promoting misleading information on the safety and effectiveness of opiate drugs to the healthcare community.
What Painkiller Addicts Say
Judging from the numbers of written prescriptions alone, it’s easy to see that American doctors play at least some role in the prescription addiction crisis. But what do those struggling with addiction say? Join an addiction support forum or meeting, and you will notice that many do indeed blame their doctors. Often, their addiction started with a written prescription for an injury or recovery from surgery. “When I told [my doctor] the pain was not going away, he just kept increasing my dosage,” states Mary, a patient now struggling with addiction. “If I ran out of pills … the doctor at the pain clinic would write me a second scrip. By the end of the first year, I realized that I had become an addict.”
Other addicts, however, blame themselves, stating that it’s “too easy” to deceive the physicians and nurses in the ER when they need their next fix, and sometimes even easier to simply score their painkillers from well-meaning friends and family. An addict can sometimes be driven to do anything to get a substance, and the current system doesn’t stop them from doing so.
What Doctors Say
Doctors and other healthcare professionals recognize the scope of the problem, but many contend that they are caught between helping patients in pain and curbing abuse at the same time. On the one hand, there are the addicts who need rehabilitation, but on the other hand, there are the patients with debilitating chronic pain who need opiate painkillers in order to function. Adding to the confusion is the fact that withdrawal from opiates can be extremely painful. “It’s difficult to tell the difference between a patient in pain from a medical condition, and a patient in pain from opiate withdrawal,” states one ER doctor from Maryland. “We cannot easily determine who is coming in with an agenda.” Outside help, these doctors say, is desperately needed in order for them to identify patients struggling with addiction.
The Future of Prescription Painkillers
There’s no doubt that America’s painkiller addiction epidemic isn’t going to resolve itself, especially since the current healthcare and public environment appears to be contributing to the problem. Some communities have already taken up changes in an effort to help doctors identify who has a legitimate condition, and who is shopping around for the next fix. These state-run programs, called Prescription Drug Monitoring Programs (PDMPs), allow greater distribution control and data collection, making it easier for hospitals, pharmacists and doctors to identify patients who “doctor shop” for their drugs. PDMPs appear to be working, but still need to be expanded and refined in order to really curb prescription drug abuse.
How can American doctors prevent the current painkiller epidemic without restricting access to pain meds to those who really need them? It’s a difficult question to answer, and one that shouldn’t rest completely on the doctors. Drug abuse, after all, is a burden that affects the community as a whole, and it will probably take a community effort to put a stop to it.