Epidemic. That’s the word out of the CDC. And the south is ground zero for the over prescribing and subsequent deadly overdose of painkillers and sedatives. Drugs range from Oxycodone to hydrocodone.

It should be noted that the increase in awareness is making it harder for patients that have a legitimate need to get the medicine they require. That always seems to get lost in the discussion. The pendulum swings either way, but fails to find a happy middle.

“Prescription drug overdose is epidemic in the United States. All too often, and in far too many communities, the treatment is becoming the problem,” said CDC Director Tom Frieden, M.D., M.P.H. “Overdose rates are higher where these drugs are prescribed more frequently. States and practices where prescribing rates are highest need to take a particularly hard look at ways to reduce the inappropriate prescription of these dangerous drugs.”

One piece of good news in the new report is Florida. The state had been known as a conduit of prescription medications. People would fly to the pain clinics to fuel their addiction. Doctors are becoming more aware of the problem, and the number of prescriptions have dropped, and so have the deaths.

Places like Alabama, Tennessee and West Virginia remain at the top of the list for painkiller prescriptions per person. Tennessee has started a program that created a registry that prevents doctor shopping. That is when a patient jumps from doctor to doctor to get opioid prescriptions. It has cut the number of patients seeking multiple prescriptions by 36%. This in turn has lowered the overdose rate.

Now comes the point of where we have to do better. The CDC has recognized that and continues to push states to implement reforms. 46 deaths per day in the United States is 46 too many.

“We know we can do better. State variation in prescribing shows us that the over prescribing of opioids can be reduced safely and feasibly,” said Daniel M. Sosin, M.D., M.P.H., F.A.C.P., acting director of CDC’s National Center for Injury Prevention and Control. “Improving how opioids are prescribed will help us prevent the 46 prescription painkiller overdose deaths that occur each day in the United States.”

The report, titled Vital Signs, lays out a multitude of steps states can take to battle prescription drug abuse.

Considering ways to increase use of prescription drug monitoring programs, which are state-run databases that track prescriptions for painkillers and can help find problems in over-prescribing. Impact of these programs is greater when they make data available in real time, are universal (used by all prescribers for all prescriptions for all controlled substances), and are actively managed (for example, send alerts to prescribers when problems are identified).

Considering policy options, including laws and regulation, relating to pain clinics to reduce prescribing practices that are risky to patients.

Evaluating their own data and programs and considering ways to assess their Medicaid, workers’ compensation programs, and other state-run health plans to detect and address inappropriate prescribing of painkillers.

Identifying opportunities to increase access to substance abuse treatment and considering expanding first responder access to naloxone, a drug used when people overdose.

Some of these are sure to run afoul of privacy advocates, but surely they will be able to find a happy medium. With the problem reaching epidemic proportions, continued action is necessary on this front.


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