Here’s a startling fact: Indiana has the 17th highest drug overdose mortality rate in the U.S., with 14.4 per 100,000 people suffering drug overdose fatalities. According to a new report, Prescription Drug Abuse: Strategies to Stop the Epidemic, the number of drug overdose deaths in Indiana quadrupled since 1999 when the rate was 3.2 per 100,000. Even more startling? A majority of these overdose fatalities are from prescription drugs.
Unfortunately, pain is an epidemic in our society that for the appropriately screened and selected patients, requires medication for relief.
Prior to using opioid medications, a good pain management physician would use a more conservative approach such as physical therapy, interventional procedures, and non-opioid medications.
In many instances, a physician who is trained and board certified in pain medicine can employ a combination of multi-modal approaches to relieve the pain and improve function. However, in some circumstances, opioid-containing medications are needed and can be very effective.
Federal health officials state that more than 115 million people in the U.S. suffer from pain, and some are our friends and neighbors. These people are cancer patients, migraine sufferers, people recovering from invasive neck and back spine operations, and many others for whom pain is a daily occurrence. Without prescription painkillers, these people would have an extremely compromised quality of life – one that many of us who are well and pain-free are lucky enough not to suffer from.
So how do we ensure that people in chronic agony are able to receive the medications that allow them to go on with daily living, even living well, while also avoiding drug abuse and addiction? How do we stay well, live well, and stay safe from what has become an epidemic of drug abuse?
The solution is a strategic and comprehensive one. Data show that 70 percent of medications abused are not actually prescribed to the individuals abusing them, or are taken in a way that is not intended. Those who abuse painkillers often crush the pills and then inject or inhale them. As part of a comprehensive solution, we need pharmaceutical companies to do their part in making it harder for people to misuse prescription opioid medications in these ways.
Fortunately, there are several companies that have begun to incorporate abuse-deterrent technology in their prescription pain medications. The technologies work in several ways, sometimes making pills impossible to crush or changing them into a thick substance that cannot be injected if heated. The technology acts as a barrier to prevent misuse, while enabling patients to get the medications they need.
The FDA has raised standards for physicians to follow, providing a subjective checklist to gauge patients’ pain. Physicians now must observe various important markers of the patient’s functionality. These standards are also a step in the right direction.
Indiana physicians have a choice when deciding what to prescribe a patient in need. With abuse-deterrent formulation opioids more available, I encourage all physicians to use them when they can so we can treat pain and continue saving lives.
Dr. Daniel Roth is board-certified in pain medicine and physical medicine and rehabilitation and practices interventional pain management at Summit Pain Management in Fort Wayne, Ind. He is a leading member of the Indiana Attorney General’s Prescription Drug Abuse Prevention Task Force, and he is also on the Board of Trustees for the Indiana State Medical Association.
