Our Editorial: Doctors key in halting painkiller abuse


Deaths from legal narcotics in Michigan have increased five-fold over the past 15 years, giving the fight against drug abuse a new twist. Gov. Rick Snyder is targeting the misuse of prescription medicine as part of his campaign to reform all aspects of criminal justice.

This is a problem that hasn’t received nearly as much attention as the war on illegal drugs, but it is killing more than 200 state residents a year, and must be taken seriously.

Snyder has charged Lt. Gov. Brian Calley with leading a task force that will issue recommendations soon.

Combating prescription painkiller abuse is made more difficult because, for the most part, the narcotics are obtained legally. Patients get their drugs from their physician, not a street dealer.

More than 75 percent of those who die of opiates have valid prescriptions, written by doctors. Most did not mix their medicine with alcohol or an illegal drug such as heroin or cocaine. For the most part, the deaths were accidental.

It would seem, then that the first line of defense is educating both doctors and their patients about when opiates should be prescribed for pain, for how long, and how they should be used.

Pain management became a priority for medical professionals in the 1980s and 1990s, when patient advocates protested that too many people were living diminished lives due to chronic suffering that could be managed through medicine.

Drug companies picked up the message, and began marketing opioid drugs such as oxycodone and hydrocodone.

Prescriptions for medications such as Vicodin and Percocet soared between 1999 and 2010. Unfortunately, so did overdoses and deaths from prescription narcotics.

The Michigan Automated Prescription System, which tracks controlled drugs, reports that in 2013, 20.8 million prescriptions for those opioids were issued, amounting to 1.4 billion pills. Currently, there are 149 such pills in circulation for every resident of Michigan.

In Michigan, hydrocodone-based drugs are the most prescribed medicine, accounting for nearly one-third of all prescriptions.

It is a problem across the nation. Since 1999, the number of deaths in the United States from prescription opioids has doubled.

Doctors must be encouraged to be more judicious in the writing of prescriptions. Opioids should be used for acute pain, and even then far more sparingly than they are today.

Chronic pain would be more safely addressed with ibuprofen or acetaminophen, the drugs found in medicines such as Motrin, Advil and Tylenol.

Patients should be better informed of the addictive nature of opioid pain-killers, and their other side effects, including the disruption of breathing patterns during sleep. Also, when combined with alcohol, the painkillers can be deadly.

Doctors should also avoid prescribing escalating doses of opioids when pain persists.

Better education and more responsible pain management practices are key tools in battling an affliction that is costing to many Michigan residents their lives.