Health care providers wrote 259 million prescriptions for painkillers in 2012, enough for every adult in the U.S. to have a bottle of pills, according to the Centers for Disease Control and Prevention.
Gary Tennis, secretary of the Department of Drug and Alcohol Programs (DDAP), said that since 2000, prescription drug and heroin overdoses have quadrupled.
“There was a shift in prescribing practices starting about 15 years ago where there was an effort to eliminate all pain," he said. "I think at that time the medical profession felt the threat of addiction was overstated. I think we’ve learned that it was not overstated that in fact we’re getting enormous numbers of people addicted to prescription opioids, and then some percentage of them are ultimately transitioning to heroin.”
Tennis said many heroin users didn’t become addicted by starting with recreational drugs but rather were prescribed painkillers. He recalled meeting with a veteran who had been wounded in Iraq.
“[He] was prescribed opioids and got addicted and ultimately transitioned to heroin and then ultimately got involved in the criminal justice system, where ironically enough he got in to Veterans Court and got referred to good treatment, and he’s back on his feet again.”
Between 2009 and 2013, about 3,000 heroin-related deaths were identified by Pennsylvania coroners. Allegheny County Medical Examiner Dr. Karl Williams said, often times, heroin is “easily available” and “cheaper” than prescription painkillers.
“We (Pennsylvania ranks) rank 14th in the country for drug overdose mortality rate, most of those overdoses involve prescription drugs, we have the third-highest rate of heroin abuse in the country,” said Cumberland County District Attorney Freed. “Deaths from drug overdoses outnumber deaths from motor vehicles in this commonwealth.”
To reduce prescription drug abuse and overdoses in the state, DDAP and the Department of Health are creating the Safe and Effective Prescribing Practices and Pain Management task force.
Tennis said this problem affects one of four families in Pennsylvania, and that "these guidelines will significantly reduce the chance that more Pennsylvanians will become addicted to prescription opioids in the future.”
He said the medical community is realizing the goal cannot be “the elimination of pain.”
“It has to be restoring functionality, and sometimes we have to learn to live with a certain level of pain, maybe not too much but in order to be clear and avoid being addicted, we may need to understand there’s a difference between having pain, some low levels of pain, and suffering,” Tennis said.
According to Tennis, the guidelines recommend that non-cancer chronic pain is best treated through an interdisciplinary approach including physical therapy, behavioral therapy, electronic stimulation and “careful use of medications as needed.”
Another goal of the task force, which is comprised of health care professionals and representatives of associations and regulatory agencies, is to ensure that prescribers are able to identify abuse and addiction problems in patients so they can be referred to appropriate treatment.
The state House and Senate are considering bills to create a Prescription Drug Monitoring Program in the commonwealth, which has helped reduce abuse and addiction in other states including Ohio.
“If somebody’s coming in and they’re doctor-shopping and they’re going from one doctor to the next because they’re addicted or in some instances they’re criminals and they’re taking it and selling it on the street, it gives the doctors tools they need to spot that and not feed into that,” Tennis said.