By Kari Knutson, La Crosse Tribune, Wis.
(MCT)
Nov. 05--Deaths from prescription painkillers are on the rise, tripling nationwide in
the past decade.
Almost 15,000 people died in 2008 compared to the 4,000 deaths in 1999,
according to a recent report from the Centers for Disease Control and
Prevention. Since 2000, 53 people have died of a prescription drug overdose in
La Crosse County, according to the medical examiner's office.
The news may come as a shock to many, but not to doctors.
"Each year the numbers come out, more and more people start talking about
this as an epidemic," said Dr. Michael Dolan, an internal medicine physician
at Gundersen Lutheran. "It's truly disturbing."
The reasons for the increase in prescription painkiller abuse are many.
Ease of access is one of the biggest contributors, Dolan said.
Doctors switched to prescribing medication electronically when people
began stealing prescription pads to acquire drugs illegally.
Still, someone who wants to find drugs usually can.
"The Internet is a game changer," Dolan said. "It allows people to
connect in both positive and negative ways."
One Oxycontin pill can sell for $20 to $25, making a bottle of 100 a
lucrative commodity.
"There's definitely a profit motive," Dolan said. "It's important that
these prescriptions be better tracked than they are."
Patients at Gundersen sign a Chronic Pain Management Agreement with
conditions for treatment that include getting their prescription only from one
doctor and one pharmacy.
Many addicts start out with a legitimate need for medication but end up
losing control, said Dr. David Onsrud, medical director of the Chemical
Dependency Residential Unit at Mayo Clinic of La Crosse.
"It's a pretty euphoric high," Onsrud said. "Opiates have always been one
of the leading drugs of choice."
The CDC's report shows nearly 5 percent of Americans 12 and older said
they've abused painkillers in the past year by using them without a
prescription or just for the high.
Complicating the problem is an emphasis for physicians to better manage
patient pain. Where once certain opiates were given only to patients with
cancer, doctors now prescribe them for other illnesses.
The overdose deaths reflect the spike in the number of narcotic
painkillers prescribed every year -- enough to give every American a one-month
supply.
Some doctors still hesitate to prescribe painkillers to patients. Others
are loose with the pen, Onsrud said.
"Doctors are trained to believe and trust their patients," Onsrud said.
"They assume they're honest. That's ingrained in the physician. You start with
that mindset, and someone trying to manipulate you to get drugs doesn't have
much trouble."
A federal drug plan announced this year calls for state programs to track
prescriptions. All but two states -- Missouri and New Hampshire -- have
approved them. But a number of states, including Wisconsin, don't have them in
place or doctors aren't using them enough to check their patients' past
prescriptions.
Local doctors say awareness is good; more training and monitoring is
necessary.
"Physicians have remarkably little education regarding addiction," said
Dr. William Bucknam of Gundersen Lutheran Medical Center. "There is a move
afoot to correct that."
More training is being offered so doctors can better recognize the signs
of addiction. They're also looking at patient history more thoroughly so they
can see which patients may have a personal or family history of addiction.
The American Board of Addiction Medicine was founded in 2007 with the
mission of giving certification to physicians who successfully complete an
evaluation process with specific criteria demonstrating their knowledge of
patient care in addiction medicine.
With more attention given to the potential dangers of prescription
painkillers, many patients are concerned about their own potential to become
addicted.
"The pendulum could swing to the opposite end where people become
phobic," Bucknam.
While the potential for abuse exists with all drugs, doctors emphasize
that prescription painkillers are beneficial for the right patients in the
right doses.
"Everything goes in cycles," Bucknam said. "What's going to be pivotal in
turning this around is physician education."
The Associated Press contributed to this story.
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(c)2011 the La Crosse Tribune (La Crosse, Wis.)
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