States and Painkiller Overdoses

By THE EDITORIAL BOARDJULY 3, 2014

There are big differences among the states in the rates at which opioid painkillers are prescribed — differences that can’t be attributed to disparate rates of illness or injury. Unfortunately, in places where prescribing rates are high, so are death rates from overdoses.

Opioid painkillers like Vicodin and OxyContin may well be overprescribed in virtually every state, but they are egregiously overprescribed in several Southern states, led by Alabama and Tennessee. Doctors in Alabama, the highest-prescribing state, wrote three times as many prescriptions per person for opioid painkillers in 2012 as doctors in Hawaii, the lowest-prescribing state, and federal officials think even Hawaii’s rate is too high.

There is a lot that states can do to stop careless — or drug-dealing — doctors from driving the opioid crisis. In a report this week, the Centers for Disease Control and Prevention credited Florida with achieving the first substantial decline in prescription drug overdose deaths in the past decade. That death rate dropped by 23 percent from 2010 to 2012, and the death rate for oxycodone, one of the most widely abused drugs, dropped by more than half over the same period.

Nationally, Florida had been home to 98 of the 100 doctors dispensing the highest amounts of oxycodone directly from their offices. Now, none of Florida’s doctors are among the top 100. It accomplished this by cracking down on so-called pill mills, forcing 250 pain clinics to close, requiring pain clinics to register with the state, prohibiting doctors from dispensing opioids from their offices, and monitoring what narcotics were dispensed.

No other state is dealing with the same level of overprescribing that Florida has now managed to reduce. Each state is apt to face a different constellation of drug problems and questionable medical practices. But the lesson from Florida is that a multipronged approach and the will to crack down can save a lot of lives.

 

Men, Opiods, and Low Testosterone Levels

As a man, with chronic pain, and taking long-acting pain meds, I found this article interesting and yet disturbing at the same time. What are we to do? We take pain meds to get through the day and then have to add a testosterone supplement later in life? I by no means think that life is fair, but can’t we catch a break? Just an itsy-bitsy one?

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Men Taking Long-Acting Chronic Pain Meds Five Times More Likely to Have Low Testosterone Levels

Jan. 31, 2013 — Low testosterone levels occur five times more often among men who take long-acting instead of short-acting opioids for chronic pain, according to a new Kaiser Permanente study published in The Clinical Journal of Pain.

While it has been known that opioids cause low testosterone in men, this study is the first to show a significant difference in risk between short-acting (immediate release) and long-acting opioids.

The 81 men in the retrospective study were between 26 and 79 years old (median age 51) and were seen in the chronic-pain clinic at Kaiser Permanente’s Santa Rosa Medical Center (Calif.) between January 2009 and June 2010. All of the participants had been on a stable dose of an opioid for at least three months, and none had a previous diagnosis of low testosterone. A larger retrospective study of more than 1,500 male pain patients is currently under way.

“There’s a large gap in the evidence base with regard to opioids,” said Andrea Rubinstein, MD, of the Departments of Chronic Pain and Anesthesiology, Kaiser Permanente Santa Rosa Medical Center. “More safety and efficacy studies are needed. We need to know how we can prescribe these very useful medications in a way that brings the greatest benefits to our patients, without introducing additional risks.”

Once prescribed primarily to cancer patients, the use of opioid-based medications such as oxycodone (Oxycontin) and hydrocodone (Vicodin) for treating chronic, non-cancer pain has increased dramatically in recent decades. An estimated 4.3 million Americans use opioids on a daily basis for pain.

 

Wisconsin Doctors to Start Prescribing “Tough Love”?!

I HATE articles like this. I believe that true chronic pain sufferers have enough to deal with in their care to be worrying about things like this. Doctors realize that chronic pain is a real condition needing real therapy. However, until a good one is found, some of us are left to fend with pain meds instead. I bet that I can ask any others like me and they would say the same thing, “find me something that works and I’ll flush these pills in an instant.” People don’t seem to realize that we DON’T want to take pills. We want to feel better. We want to be able to do the things in life that “normal” people do. Like I said previously, it’s hard enough without drug abusers getting in the way.

I have a better idea! How about doctors prescribe a visit to a therapist WITH the prescription? That way, we can get the meds that we need while also getting the much needed counseling in order to deal with the feelings and emotions that come from a debilitating life condition? That way you leave labeling an addict to a psychological professional and not your opinion. I’m sure that a counselor can see between the lines to determine whether you legitimately need pain meds or not. I feel that we need chronic pain sufferers making these rules (or at least previewing them) instead of doctors or politicians that are slave to their personal views and not what’s always best for those that need help. </rant>

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Area ER Doctors To Limit Who Gets Prescription Pain Meds

As prescription pain medication abuse continues to rise, area emergency rooms will likely go Oxy Free in the next few months, meaning patients might get a little more tough love.

By Denise Lockwood
July 27, 2012

Fed up with patients that don’t have legitimate reasons for taking prescription pain medications, emergency room physicians in southeastern Wisconsin will soon be giving large doses of tough love to patients who are doctor shopping.

Nationally, narcotic prescription medication abuse, including abuse of oxycodone and oxycontin, is on the rise. So within the next few months hospitals in Milwaukee County are going “Oxy-free” and a Racine-based emergency department is also looking into doing the same. The information-sharing group includes officials from Froedtert Hospital, Wheaton Franciscan, Columbia-St. Mary’s, and Aurora Health Care.

Dr. Gary Swart, medical director for the emergency departments at Wheaton Franciscan’s Elmbrook Memorial, St. Joseph and The Wisconsin Heart Hospital campuses, said he’s part of a network of emergency department administrators that will be implementing tighter restrictions on how prescription pain medications are used and they want their patients to know about their policies prior to registering.

 

False Drug Shortage Due to Discrimination of Chronic Pain Sufferers

As I was scouring the net late at night I found the article before that had me sitting there wondering… WTF? It is hard enough to go through life with not only chronic pain, but also the stigma that comes when trying to order the medication necessary for relief. I’ve personally experienced it nearly every time I’ve been to the pharmacy. The pharmacist (or rather the person working behind the counter) is always friendly UNTIL they see the script. Their eyes lower to the floor and you can tell that they are trying to treat me as if I am some sort of delicate situation. However, the script always gets filled. Now, I’m in no way “pharmacy shopping” but since I do not have prescription insurance, I sometimes go elsewhere where my meds are cheaper. The article below takes this to a whole new level. Flat out lying to patients is never acceptable. For someone to flat out lie and deny you medication based on their personal beliefs is an atrocity. Please read the article below and share your comments.

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Drug shortage ups suffering for legitimate pain patients
By Marni Jameson, Orlando Sentinel
7:46 p.m. EST, July 10, 2012

Last week, former TV anchor Carole Nelson watched the clock, knowing that in just a few hours she would face the agony of drug withdrawal made worse by paralyzing pain.

Her last oxycodone pill would wear off in 24 hours. She needed more.

However, during the prior 10 days, Nelson had been to 15 pharmacies trying to fill her prescription for the pain medication she has taken steadily for three years. Oxycodone, an often-abused narcotic, is the only treatment of many Nelson has tried that manages her chronic lower-back pain, the result of a seriously damaged and deteriorating spine.

No pharmacy would fill it.

“They all said they didn’t have any and didn’t know when they would get it,” said the 74-year-old professor, who lives in Volusia County.

It’s a line pain patients are hearing all over Central Florida as the crackdown on the state’s pill mills has begun to restrict the flow of pain medications to legitimate patients.

“When these medications aren’t available, it undermines the whole basis of pain management — which is about stabilizing pain,” said Dr. Peter Preganz, who treats chronic-pain patients, including Nelson, at his Lake Mary office.