Forty-four Americans die every day from prescription pain killers such as oxycodone, hydrocodone and morphine, but they all include the drug heroin and new research and information is helping doctors learn more about the epidemic.
"They are literally dying every single day," said a former addict.
When powerful pain killers are legal and easy to get, that’s a recipe for addiction, and all too often, death.
"If you didn’t know someone who could get them, they knew someone who could get them, or somebody knew somebody," said a former addict.
The pain pills work, until that awful day they turn against you.
"I woke up the next morning with a chipped tooth and blood on my face sitting in a pile of my own urine," said a former addict.
More than a quarter billion opioid prescriptions were written in 2012. Of course, many are valid, but according to doctors they can be a gateway to more dangerous drugs.
"Prescription pain medications can be a gateway to heroin use," said Dr. Martin Klapheke, the assistant dean of medical education at the UCF College of Medicine.
In fact, four out of five new heroin addicts started with prescription pain medications.
"This isn’t about blaming the patient or the doctor, it’s about increasing our knowledge of the evidence base," said Dr. Klapheke.
This epidemic sparked research and now doctors know there are other options.
"There are some anticonvulsants like pregabalin, carbamazepine, gabapentin, there’s some antidepressants actually like duloxetine that have been shown to be effective in treating pain," said Dr. Klapheke.
Doctor Klapheke says when it comes to opioid prescription training, medical schools have long fallen short. He says we need to do much better educating young and practicing doctors about preventing overdose deaths and about making treatment more readily available for addicts.
"it’s the clinical science years that we really want to focus on now and beef up and have the students have more opportunities to apply this to actual clinical cases," said Dr. Klapheke.
Doctors need to step up and pay closer attention and future doctors are becoming more aware of the problem.
"They have to do a urine drug screen every month when they come and visit to prove they are not on any other medication," said Tavya Benjamin, a 3rd year medical student at the UCF College of Medicine.
"When I think about pain management i think of a very narrow range, like anti-inflammatories, tylenol, ibuprofen. I think there are many other effective medications or therapies that people can try before they go to opioids," said Ashley Franklin, a 3rd year medical student at the UCF College of Medicine.
UCF and more than 70 other medical schools have signed a pledge to educate their students. Doctors and pharmacists are trying to make naloxone a life-saving antidote for overdose and more readily available to prevent deaths.
In most states this is now available to the patient or family or caregiver, without a prescription. Doctor Klapheke says another part of the answer is prevention.
PRESCRIPTION, ADDICTION AND EDUCATION
BACKGROUND: According to the American Society of Addiction Medicine, of the 21.5 million Americans 12 years or older who had a substance abuse use disorder in 2014, 1.9 million involved prescription pain relievers. Opioids are medications that relieve pain. They work by reducing the intensity of pain signals being sent to the brain and affecting the brain areas that control emotion, which reduces the effects of a painful stimulus. When taking opioids, it is possible to become tolerant to them, meaning more is needed to obtain the effects. It is also possible to become dependent upon opioids, meaning a sick feeling occurs without them. Dependence is different from addiction; however, dependence can lead to addiction in many cases. Between 26.4 million and 36 million people suffer from an opioid addiction worldwide. The number of recent deaths caused by an overdose of painkiller drugs has more than quadrupled since 1999. Every day, 44 people die of opioid overdose. Several factors have contributed to the climbing numbers of opioid abusers, such as drastic increases in the amount of prescriptions written and dispensed, greater social acceptability for using medications for different purposes and aggressive marketing by the pharmaceutical companies. Opioids are most dangerous when taken using methods to increase the euphoric, or “high”, effect: crushing pills up and snorting or injecting the powder, or combining them with alcohol and other drugs.
(Source: http://www.drugabuse.gov/publications/research-reports/prescription-drugs/opioids/what-are-opioids, http://www.drugabuse.gov/about-nida/legislative-activities/testimony-to-congress/2015/americas-addiction-to-opioids-heroin-prescription-drug-abuse, http://www.asam.org/docs/default-source/advocacy/opioid-addiction-disease-facts-figures.pdf)
TRAINING: The University of Central Florida is one of more than 70 schools across the country to take the pledge to teach more medical students about prescribing opioids. UCF’s curriculum already included things such as patient safety, ethics and prescribing opioids but Doctor Klapheke, a leading UCF task force for this project, wanted to delve into the topic even more. He said the goal is to give future doctors more evidence-based recommendations for issues like when to prescribe opioids and what the other options are. He also said physicians have not been trained enough about prescribing prescription drugs, he recalled when he was in med school that he was taught more information on prescribing antibiotics than pain killers. Other schools that have taken the pledge include: Tulane, Tennessee, Ohio State, Rutgers, Louisville, Wisconsin and Baylor.The CDC has reported that three out of four people using heroine started with prescription opioids, making this pledge vital to society and slowing down the heroine addiction epidemic.
MORE FROM DOCTOR KLAPHEKE: “Do not forget the needs of the families of patients who are struggling with opioid addiction. Free self-help groups, such as Nar-Anon, are available for family members.” Go to www.nar-anon.org.
For More Information, Contact:
Martin Klapheke, MD
Assistant Dean of Medical Education
Professor of Psychiatry
University of Central Florida College of Medicine