Last week the Woodstock Times and Daily Freeman both reported that a Woodstock doctor was arrested by federal agents on a charge of unlawful distribution of a controlled substance. He is accused of prescribing large quantities of the powerful painkiller hydrocodone (Vicodin®), among other drugs, without a legitimate medical purpose.
The doctor only accepts cash payments and was among the top five prescribers of hydrocodone in the area covered by the FBI’s Albany division. The doctor wrote 9,940 hydrocodone prescriptions between December 15, 2010 and January 17, 2012 accounting for nearly 85 percent of all of the prescriptions that he wrote during that period. The complaint states that approximately 4,520 of these prescriptions were for patients under 35 years old.
Many residents have rushed to his defense, and the doctor has stated that he is innocent of the charges and believes that he will be exonerated. We can’t and shouldn’t rush to judgment and will wait to see how this case plays out in the legal system.
However, this event provides an opportunity to talk about the role of physicians in preventing prescription drug abuse. The Centers for Disease Control declared in 2011 that prescription painkiller overdoses are a public health epidemic. Overdose deaths from prescription painkillers have skyrocketed during the past decade.
Nearly three out of four prescription drug overdoses are caused by prescription painkillers such as hydrocodone (Vicodin®). The CDC states that this parallels a 300% increase since 1999 in the sale of strong opioid pain relievers.
Almost all prescription drugs involved in overdoses come from prescriptions originally; very few come from pharmacy theft. However, once they are prescribed and dispensed, prescription drugs are frequently diverted to people using them without prescriptions.
Enough prescription painkillers were prescribed in 2010 to medicate every American adult around the clock for one month. Most prescription painkillers are prescribed by primary care and internal medicine doctors and dentists, not specialists. Roughly 20% of prescribers prescribe 80% of all prescription painkillers.
Clearly prescribers are the first line of defense in preventing prescription drug abuse.
The CDC recommends that health care providers follow guidelines for responsible prescribing, including:
· Screening and monitoring for substance abuse and mental health problems.
· Prescribing painkillers only when other treatments have not been effective for pain.
· Prescribing only the quantity of painkillers needed based on the expected length of pain.
· Using patient-provider agreements combined with urine drug tests for people using prescription painkillers long term.
· Talking with patients about safely using, storing and disposing of prescription painkillers.
· Use Prescription Drug Monitoring Programs to identify patients who are improperly using prescription painkillers.
Effective prevention strategies must include engaging all key community members such as doctors, physician’s assistants, nurse practitioners, nurses, pharmacists, dentists, counselors, first responders, hospital personnel, teachers, counselors, school nurses, coaches, administrators, parents, youth, youth activity leaders and faith communities in the dialog to educate all sectors of the community and address local prescription drug misuse conditions.
Director, Ulster Prevention Council