Wednesday, July 16, 2014
Prescription drug abuse is a national epidemic. According to a recent report by the Trust for America’s Health, prescription drug-related deaths now outnumber those caused by cocaine and heroin combined. Fortunately, South Carolina has just become the latest state to join the fight against this epidemic.
Gov. Nikki Haley recently created the Prescription Drug Abuse Prevention Council. The council, which includes representatives from the Department of Health and Human Services and several other state agencies, is examining the problem of prescription drug abuse and developing a proactive plan to combat it.
The Pain Society of the Carolinas, a nonprofit organization representing more than 200 physicians who treat chronic pain, also has been focused on developing recommendations to eradicate prescription drug abuse. We know, however, that success in this battle requires more than cooperation from the medical community.
More than 70 percent of Americans who abuse prescription pain relievers get them from friends or relatives rather than directly from a physician, according to the National Survey on Drug Use and Health. That means the battle against prescription drug abuse requires a community-based approach to educate patients and their families. It won’t work to simply target physicians and reduce the number of prescriptions.
Chronic pain is a debilitating condition that threatens the livelihoods of patients, and treatment can require medications that carry a risk of dependency and abuse. The reality is that we need doctors to manage chronic pain as a facet of a person’s overall health, not shy away from treating patients living with pain.
After Florida passed legislation in 2011 aimed at limiting the number of narcotic prescriptions, many physicians — afraid that they might inadvertently disobey the law — stopped prescribing pain medications altogether or even treating patients with chronic pain. Legislation that encourages indiscriminate reductions in prescriptions and pills will only hurt patient care — and it may even enable so-called pill mills by driving patients away from responsible physicians.
The Prescription Drug Abuse Prevention Council should focus on providing community-wide solutions to ensure that medications don’t end up in the wrong hands, while empowering the medical community with guidelines for safely prescribing pain medications.
Effective, safe prescribing practices should include taking a patient’s full medical history and performing a physical examination; considering the risks, benefits and alternatives to prescribing a narcotic; routinely consulting the state’s prescription monitoring program; testing patients for prescription and illicit drug abuse; and meeting an education requirement to acquire or renew a physician’s Drug Enforcement Agency registration to prescribe controlled substances.
Medical practices specializing in the treatment of pain should be owned and operated by board-certified physicians who are held to the highest standards of education and training.
That’s why the governor’s council should require pain-medicine practices to register as such with the South Carolina Department of Labor, Licensing and Regulation. Additionally, insurance companies should be required to include abuse-deterrent medications on their prescription formularies.
These reforms will promote safe prescribing without stifling access for patients who truly need prescription medicines to manage their pain.
To effectively fight prescription drug abuse, South Carolina should balance the need for enforcement and prevention with the need for appropriate access. We need to educate the community about the risks of medication-sharing, while creating a safe environment for physicians to responsibly treat patients living with chronic pain.
Dr. Warrick is a board-certified pain specialist, member of the Pain Society of the Carolinas Advocacy Committee and secretary/treasurer of the Sumter, Clarendon, Lee County Medical Society.