Step up fight against ruinous prescription painkiller abuse

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If it is confirmed that the musician Prince died from the overuse of prescription drugs, as seems likely, it will only highlight a scourge that has doctors across the country worried: an epidemic of pain drug addiction and deaths.

Curbing the epidemic demands a more nuanced way by medical professionals of treating pain, one responsible doctor at a time.

Two decades ago, pharmaceutical companies started selling more drugs in a class called opioids, and doctors began prescribing more of them, although they don’t work in all cases. At the time, it was seen as a way to help patients cope with pain, and in 2000 a federal commission set treatment of pain as a priority. But opioids are a two-edged sword: just as they can be powerful and effective against pain, they also can be ruinous if used improperly. Not only are they highly addictive, but they can affect the brain to the point that people don’t breathe enough to stay alive.

Since 1999, the number of opioid prescriptions has shot up fourfold. In 2012, enough opioids were prescribed to give every American adult a bottle of pills. Fatalities skyrocketed in tandem. Opioids now kill an estimated 60 people a day, making prescription drug overdoses the No. 1 cause of accidental deaths in the United States and a factor in shortening the average life expectancy of the white male middle class.

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According to a poll released last month by the Kaiser Family Foundation, 44 percent of Americans say that they personally know someone who has been addicted to prescription painkillers. Some doctors say opioids are the worst drug-addiction epidemic in the nation’s history.

According to the New York Times, Prince had a problem with prescription painkillers after he started taking the drugs for hip pain, and his friends were trying to get him help just before he died. An autopsythat will verify whether he was using pain pills has yet to be released.

Opioids include morphine, hydrocodone, oxycodone and fentanyl. Brand names include OxyContin, Percocet, and Vicodin. The drugs are used to treat pain, often following a major operation, and in recent years also have been prescribed for chronic pain.

But after long use, patients can become physically dependent or addicted to the drugs. As their bodies become more tolerant, they need higher and higher doses. If they no longer can get enough drugs legally, they may buy illegally obtained drugs. If they can’t get those, or can’t afford the street price, they may turn to heroin, helping to drive up the number of fatal heroin overdoses.

The medical profession is starting to look for ways to bring the prescription pain drug epidemic under control.

Last year, Illinois enacted a law to better track painkiller prescription. In March, the Centers for Disease Control and Prevention laid out guidelines on how physicians should use opioids for treating patients with chronic pain. Last Wednesday, an FDA advisory panel voted to make opioid-prescribing training mandatory for physicians. FDA officials have said Commissioner Robert M. Califf will back the recommendation. Dr. Vivek Murthy, the new U.S. surgeon general, has said he is making the opioid epidemic a priority. Several bills before Congress are aimed at fighting prescription painkiller abuse.

To truly combat what has become a public health crisis, medical professionals on every level must emphasize non-opioid therapies whenever reasonably possible. Only then will we turn the tide away from prescription painkiller overuse.

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