“Doctors as Drug Dealers” (a statement a physician made himself): A Growing Problem


Misuse of prescription drugs is a growing health crisis. In the United States, prescription drugs kill more people than heroin and cocaine combined, a situation that the CDC (Center for Disease Control) considers the worst drug epidemic in the nation’s history. The drugs – mostly painkillers such as hydrocodone and OxyContin – aren’t coming from South American drug cartels or street corner pushers and they aren’t cooked in a back bedroom or garage. They come from doctors, most of whom are conscientious and want to help their patients who are struggling with chronic pain.
Over-prescription of prescription painkillers became a problem 20 to 30 years ago when medical providers were accused of withholding pain medications from patients who needed them. This was a valid concern at that time, especially for underserved populations who were frequently overlooked when it came to pain management.
Doctors responded to those concerns by prescribing medications for patients experiencing legitimate pain, which led to a rebound affect and a skyrocketing drug problem that continues to this day. At that time, many physicians believed that opiates were safer than Ibuprofen and other non-steroid anti-inflammatory drugs, which contribute to stomach problems and cardiac issues.
Today, the pendulum is beginning to swing back the other way. Doctors are advised to limit use of opioid painkillers and to treat acute pain with therapeutic doses of acetaminophen or ibuprofen.
There is no doubt that pain management is most effective when physicians take time to work on pain issues and communicate honestly with patients. Medical providers who reexamine prescribing practices are becoming more aware of the dangers associated with painkillers and many are writing prescription for limited numbers of pills, with clear instructions to take the medications only when absolutely necessary. Doctors are becoming more proactive by warning patients that painkillers – even in therapeutic doses – can be dangerous and highly addictive. Some require patients to sign an agreement that they won’t share pills or use medications in ways other than prescribed. Others stipulate that recipients of medications must be closely monitored for pain levels and drug use.
Government entities such as Veteran’s Administration and Medicare are also ramping up regulations governing prescription of painkillers.
Patients somehow share the “blame” for the escalating problem, many of whom believe drugs are safe when they are legitimately prescribed by physicians, and that taking pills orally presents less danger than injecting, smoking or snorting. Some patients believe that medications aren’t addictive when they are prescribed for real pain, but between 5 and 25 percent of people who use opioid pain pills will become addicted, even in the presence of very real, severe pain.
There are precautions that patients can take to minimize risk of addiction and other complications associated with use of pain pills:
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