The Prescription Narcotic Epidemic

The United States makes up 5% of the world’s population, though it consumes 99% of the global hydrocodone supply, 80% of the oxycodone, and 65% of the hydromorphone, according to an article recently published by the New Yorker. The piece was written by a young medical doctor, who has seen first-hand the rise and consequences of prescription narcotic abuse.

Sales of pain pills, such as Vicodin, Percocet, OxyContin, and Dilaudid, have quadrupled since 1999, and consequently, overdose deaths have more than tripled. Pain relievers kill more than heroin and cocaine combined, and yet they continue to be prescribed by American physicians. At the same time, four out of five heroin users have previously abused prescription pain pills, according to the head of the CDC’s prescription-drug overdose team.

Many doctors are driven to prescribe by the pharmaceutical companies that manufacture these drugs, patients, health insurance companies, and their peers. Only a short while ago, painkillers were prescribed exclusively for relief of short-term (acute) pain, such as to cancer patients or post-surgery. Now, one can easily walk into an outpatient clinic with complaints of chronic back pain and receive a prescription for OxyContin.

Despite this, there are no credible studies or trials that show that narcotics can reliably or effectively treat chronic pain unrelated to cancer symptoms. The issue has become so egregious that, in October 2013, the FDA started limiting the distribution of pain pills, how they are prescribed and refilled. The FDA refers to the abuse as an epidemic, and is recommending that doctors start prescribing painkillers only in 90-day supplies (presently they are available in six-month quantities). The agency also wants patients to physically bring in the prescription papers instead of having them called in.

These recommendations, if accepted, will have far-reaching impacts due to the huge inventory of prescriptions. It would, ideally, curtail much of the abuse. It may also adversely affect patients who genuinely need the medications, such as cancer fighters and residents of nursing homes, who have less access to doctors and pharmacies.

The question of how doctors let the issues get so out of hand remains. Prior to the 1990s prescription narcotics were used primarily as alternative therapies, for use only by select patients. Around the late 1980s, pharmaceutical companies (including Johnson & Johnson, and Purdue Pharma) started forcefully marketing their painkillers for treatment of chronic, non-cancer related pain through courses and seminars for medical professionals.

As a result of investigations, three of Purdue Pharma’s top executives pleaded guilty to misleading the FDA, patients and medical professionals regarding the risks of OxyContin in 2007. They were charged criminally for their aggressive and false marketing strategies and Purdue and its executive paid a total of nearly $635 million to the government for misbranding the drug.

That same year, Congress passed a law that gave the FDA increased oversight over drug advertising and labeling to restrict dangerous drug prescriptions. Three years later, Purdue reformulated the drug so that is unable to be crushed, making it less desirable to addicts. The company also now conducts an educational seminar on “responsible opioid medication prescribing.”

Although it is nearly impossible to control national pharmaceutical advertising, several states and the FDA are trying. In 2001, a dozen states proposed bills concerning advertisements that directly targeted patients. Over a decade later, ten of those states had officially enacted laws or resolutions regarding pharmaceutical marketing. Others are educating doctors on the financial impacts of their prescribing habits, and how to recommend alternative therapies to pushy patients.

The FDA and other government agencies, at present, seem committed to making these changes. Patients and pharmaceutical companies, on the other hand, are not as welcoming to the changes. Americans are deeply committed to the promise of medications and often put immense pressure on physicians.

In efforts to relieve suffering and make patients happy, doctors too often give them what they want even if they believe more strongly in alternative methods. Health insurance companies are also a major contributor to the problem, as they cover the cost of prescriptions but not always chiropractors, acupuncturists, physical therapists or mental-health providers.

Patients who overdose on narcotics may be entitled to compensation if their doctors irresponsibly prescribed them. If a doctor prescribed a painkiller in an incorrect dosage or in any other incorrect manner, and it resulted in overdose or death, the doctor or hospital may be liable. Our team of dangerous drug attorneys is currently reviewing cases of serious injury from medications, and can answer any questions you may have regarding your legal rights and avenues.