Not surprisingly, I learned of the so-called zombie apocalypse that apparently started with the face-eating incident in Miami from a bunch of teenagers, who were shocked (and … gulp … fascinated) that bath salts could bring on such an event. It sort of reminds me of the one that went around when I was younger about the guy high on angel dust who jumped out a window to his death.
Yup, don’t do drugs, they said. Cocaine, LSD, heroin, marijuana, that’s all bad news. Comic books where evil drug dealers snuck out of a grove of trees to pressure innocent kids into shooting up. The egg in the frying pan as a universal image for “this is your brain on drugs”.
But actually, yeah, I do have a question.
Why is it that everyone skirts around the fact that what are arguably the two most dangerous categories of “drugs” can be found right at home?
Let’s face it, the liquor cabinet is a dangerous place. How many people are killed each year by drunk drivers? I mean, think about it, how often do you hear about someone arrested for “Driving While Tripping”? Yet the list of DWI revocations distributed by the DMV at the end of each month is tragically long.
But don’t smoke crack, kids!
Even more silent than any of the heavy hitters or even alcohol, is the abuse of prescription medication. Men and teens are victims of this one, but this type of quiet drug abuse has long been owned by women primarily, with the concept of “Mother’s Little Helper” coming into common conversation back in the sixties thanks to the Rolling Stones.
Perhaps the biggest problem vis a vis prescription medication in 2012 is the concept of “doctor shopping” … or, well, I guess steps being taken to curtail prescription pill addicts from rotating doctors to get their prescription of choice.
Well, something’s gotta give, and a potentially mitigating circumstance seems to be on the horizon.
A CDC report last year said 15,000 people died as a result of overdoses of prescription painkillers in 2008 – more than three times the number in 1999.
Kentucky is a hot spot. Nearly 1,000 people in the state died from prescription drug overdoses in 2010, or about three a day, ranking it among the top states for such deaths.
In America as a whole, about 12 million people aged 12 and older reported non-medical use of prescription painkillers in 2010.
Abusers and dealers typically get drugs by finding doctors willing to prescribe them, forging prescriptions, theft from pharmacies or individuals, or buying from “pill mills” — storefront clinics that sell painkillers for cash up front.
The answer seems to be a database of sorts, where medical providers can quickly run a name check on a patient …
… who comes in, says, “I have back pain, and Percocet fixes it”, and expects a prescription for the requested drug.
Forty-three states now have databases to keep track of who is getting prescriptions for powerful pain relievers such as oxycodone, Vicodin and Opana.
Pharmacists enter prescriptions for controlled substances into the database, so prescribers can see if patients are getting pills at multiple locations.
Another five states have passed laws to create databases, but have not yet implemented them. Missouri and New Hampshire do not yet have such laws, though they have been introduced in the legislatures, according to Sherry Green, CEO of the National Alliance for Model State Drug Laws. There is no national database, though more states are sharing information.
It’s very easy, in an election year that’s sure to be both acrimonious and interesting, to either avoid this conversation entirely as it sort of runs counter to the “Go, states rights” rhetoric and argues for federal regulation. Wherever you stand on the political spectrum, this is a tough one. A national database of drug shoppers would almost certainly save lives … but of course the question remains of who is going to fund it.
And that’s just one of the problems.
The programs have not been without controversy, with a major issue being whether doctors should be required to check the database when prescribing addictive medicine, or whether this should be left to their discretion, said Green.
Some doctors have expressed fears that PMPs could breach patient confidentiality and interfere with needed treatment of pain or could be used against doctors who need to prescribe a lot of pain medicine.
Doctors also object to proposals they see as putting law enforcement above health care. Citing privacy concerns, the Kentucky Medical Association fought successfully against a provision that would have moved the state’s database to the Attorney General’s office, the state’s top legal officer.
It’s a tough one, all right, and I can’t imagine even considering entering the medical field when this sort of thing is on the table.
There is some evidence that the databases are leading to the prescribing of fewer addictive medicines.
According to a study by the emergency department of the University of Toledo’s College of Medicine, doctors or pharmacists who reviewed state prescription drug data changed how they managed cases 41 percent of the time.
The study found that 61 percent prescribed either no opioid medications, or less than originally planned, while 39 percent decided to provide more.
“I know a number of emergency-room physicians tell us how much they appreciate the system to discriminate between real patients with real injuries and those who just want drugs,” said Danna Droz, the administrator of Ohio’s PMP.
Speaking from personal experience, it is almost too easy to get prescription medication. I have a chronic liver/pancreas situation that allows me to get the heavy hitters pretty much at will. I suffer from migraines, and on one memorable occasion, I was given 30 Percocets and a prescription for Valium with three refills. 10 Vicodin pills for an abscessed tooth. And when I had a pinched nerve and went to the emergency room, I was given a pretty hefty Percocet script (I still had about 24 at home from the migraine adventure).
I don’t worry for myself as much because I seem to have avoided a propensity for prescription pill addiction, but the ease with which these drugs can be obtained is just scary. I have also started flushing what I don’t use, just in case … after all, it’s hard to tell when an addiction can start, and I’ve been there, done that with my ex-husband, who went from being an occasional social drinker to being admitted to the hospital with blood alcohol levels of .39-.41 (in other words, pretty much dead) on many occasions.
I worry like hell for society, though, and I think that a national database could curtail, or at the very least increase awareness of, a very serious problem.
You can’t put a dollar sign on a human life.
What do you think?