Got a headache? Take a pill. Insomnia? Take a pill. Back pain? Take a pill. Is this what healthcare has come to in America? According to many, both within and outside the medical profession, the answer is yes; our physicians are overprescribing certain medications. Though most are prescribed for legitimate reasons and taken in responsible ways, there is considerable over-prescription, particularly of pain medications known as opioids. As a result, drug intervention services for opioid addictions are widespread.
According to Dr. Jane Ballantyne, the increased use of opioids can be linked to a shift that occurred in the medical profession from the mid-eighties into the early 90’s. At this time, physicians began using opioids for the treatment of chronic pain. Previously, due to the risk of addiction, these pain medications were primarily prescribed for patients who were dying, and secondarily for post-surgical or dental pain relief. The newer, far-reaching category of “chronic pain” left room for the growing use of opioids, and as a result, a growing need for drug intervention services for addiction.
Opioids are not alone in being over-prescribed. There are 3 categories of medications that fit this description. Opioids are pain medications with familiar names like Vicodin and Percocet. Stimulants such as Ritalin and Adderall are most often prescribed for the treatment of ADHD and fall into the second group of over-prescribed medications. The third category consists of anti-anxiety medications and tranquilizers. These are the benzodiazepines (a.k.a. benzos) such as Valium, Xanax and Klonopin. Sleep medications, tranquilizers or hypnotics, such as Lunesta and Ambien, are similar to the benzos and are included in this group of over-prescribed medications.
Potential addiction for the prescribed user is only one risk associated with these types of medications. Teenagers, in particular, who find easily accessible, unfinished bottles of prescription medications in the family medicine cabinet, are vulnerable, too. Statistics show that 1in 6 teenagers (defined as age 19 and under) have used a prescription medication to get high. After marijuana, prescription medications are the drugs most abused by teenagers, and have been referred to as “the new gateway drug” – the first drug people try. There is also the potential for prescription drugs to be sold on the street.
Physicians who jumped on the “medication for chronic pain” bandwagon did so with very little training about the use of opioids. The current consensus is that primary care physicians need education about appropriate uses for opioids, and other ways of treating pain which may be more effective. A more holistic approach, for example, might include behavior and lifestyle changes, physical therapy, core strengthening and weight reduction. Rather than simply medicating the symptoms, the goal is to treat the underlying condition.
Is limiting the prescription of opioids a possible solution? One state is currently trying this approach. The state of Washington is the first state in the nation to put a limit on the amount of pain medication a physician can prescribe. The risk here is that physicians may abruptly cut people off from their medications without dealing with the addiction that has developed. The severity and dangers of withdrawal from these types of medications requires specialized drug intervention services.
If you’re concerned about your own use of pain medications, or the drug use of someone close to you, there are many excellent programs in the Boston area that can help you assess your situation and recommend treatment options. Right Turn, A Creative Approach to Recovery in Arlington, MA is an innovative program that offers comprehensive outpatient treatment and supportive housing for addiction, with expertise in the treatment of prescription drug addiction.
Reference: Right Turn Radio Show, 02/17/13 with special guest, Dr. Jane Ballantyne, Professor of Anesthesiology and Pain Medicine, University of Washington, Seattle