Prescription Drug Abuse Vs. Pain Management
I have recently become sensitized to quite a pressing issue that will come to a head in the near future - and I would like some feedback. According to the 2006 annual report of the International Narcotics Control Board, the worldwide abuse of licit drugs will surpass that of illicit drug abuse (excluding cannabis) in upcoming years, and the trafficking of these white market drugs will follow the same pattern. Particularly alarming - yet not all that shocking - is that the United States leads the way in its contribution to this international shift.
I am particularly worried about the impacts this will have on pain management in our health care system. Plenty of extant research shows that we undertreat patients’ pain - from acute to chronic - partially due to the stigma attached to our more potent pharmaceuticals as well as some of the regulations and monitoring protocol required for particular narcotics. Some physicians avoid giving out narcotic prescriptions - especially when some doctors are being prosecuted for just this reason. Take, for example, the most recent major case - that of William Hurwitz. While there may be some malfeasance on Dr Hurwitz’s behalf in this case, the conviction of a physician in this manner will definitely send shockwaves through the pain management community.
As someone who has had two family members in hospice care in the last decade, I have seen firsthand how difficult it can be to begin and maintain a sufficient pain management regiment. Even at the behest of the patient and his/her family, receiving enough pain relief can be an uphill battle.
The reason why I bring this up is that two colleagues of mine are working on a manuscript on OxyContin abuse in the United States - in particular, they find that the increased availability and popularity of OxyContin has lead to an increase in the diversion of this product to the gray and black markets, which in turn has lead to increased abuse. My initial reaction to their piece in progress was to be careful of the policy implications - if increased availability means increased abuse, then the commonsense thing to do is to reduce availability. This has been done with plenty of other dangerous medicinal products in the past - some to the point of extinction.
My argument is that there is not enough of this product as well as its narcotic kin being legitimately prescribed to patients in need. 
It seems to me that we are in dire need to fund research that will help us solve this conundrum - how can we reduce levels of licit drug abuse when in fact we already under-prescribe narcotics to our patient population in many cases/circumstances?
– Dave Khey
May 10th, 2007 at 12:37 pm
This just in! http://news.yahoo.com/s/ap/20070510/ap_on_bi_ge/oxycontin_plea
May 21st, 2007 at 11:44 pm
I would like to add my view on this subject. I have a family member that depends on Oxycontin to get through the day. My insurance no longer covers the prescription because it is too high of a dose and costs too much. Luckily we have a backup insurance that does cover it. The bad thing is that we can only get it on the last day of current months pills. This makes it extremely hard to plan for trips, hurricanes etc. I agree that this drug is abused by some but it still needs to be available to those that need it. I think that the seriousness of this drup needs to be weighed against the pain without it so that only those that trully need it get it. For those that don’t trully need it the temptation to sell for over 200 bucks a pill can be overwhelming. For those that depend on it, no amount of money would make them sell the pills. There is always going to be a black market for narcotics and that needs to be addressed without compromising the quality of lives to those in need of them.
June 16th, 2007 at 11:40 am
I would like to reply to this posting. I very much agree with what this lady is saying. I am in recovery an have been for 6 yrs. now from heavy drug abuse. I now lead a ministry recovery program in my church and have been involved with one other ministry recovery program for a year and half now. Reovery is very hard and takes a lot of work. I do think that if there is someone that really needs to take this drug to help them to function in the world as they need to than prescribe it to them. But I do believe that some insurance companies won’t pay for the drug because it is on the black market and that those that do need it may sell them/misuse them. I do know a lady that is prescribe Oxycotin an she does sell hers in the street. If it is going to be misuse than use another alternative medicine that is not on the black market and that is not so addicted. I don’t take anything and if I have to I always tell the doctor that I am in recovery from drug abuse so don’t give me anything that has a narcotic in it.
If need get it if not don’t get it, if you get and misuse than you really don’t need and a person is abusing it.
August 2nd, 2007 at 1:06 pm
The “future” you fear is aleady here. Surveys (SAMHSA) show that the first drugs that children (middle & high schools) abuse are prescription drugs, specfically pain releivers (Oxycontin/Oxycodone, Vicodin/Hydromophone, etc.)… appproximately 52% start here…vs. 48% with marijuana, and the gap is getting worse not better.
Based on research I have seen, you can argue all day about marijuana use….and its long term effects or lack thereof…
You CAN NOT argue that prescription pain reliever abuse is VERY dangerous, Addictive, potentially DEADLY, and in many cases leads to HEROIN abuse. Just look at emergency room stats (TEDS) to confirm.
Other drugs…benzos, propoxyphene, etc. also becoming prevalent.
Drug abuse is as bad, if not worse than ever.
December 31st, 2007 at 2:03 pm
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March 17th, 2009 at 12:53 pm
To control the pain we must attend to the specialist because we can give him what is appropriate and what we need, for example I take vicodin which is a medicine used to counter severe pain that I have for years, but I prescribed rioja the doctor, I take it in moderation because I read in findrxonline.com which is a medicine that causes anxiety, and we must control it as it can affect your nervous system, and not because it really automediquen could be dangerous.
April 20th, 2009 at 2:52 am
In fact, there are more among us who suffer from this problem than those who do not suffer at all! It is no wonder, then, that there are so many types of backwards discompose medication and treatments available in the market today.
October 20th, 2009 at 7:56 am
It is no wonder, then, that there are so many types of backwards discompose medication and treatments available in the market today.I read in findrxonline.com which is a medicine that causes anxiety, and we must control it as it can affect your nervous system, and not because it really automediquen could be dangerous.