Prescription Pain Medication – A Look Ahead

We need to get ready – it’s coming – and there isn’t anything that can be done to stop it. What I’m talking about is the vigorous regulation of prescription pain medications.

A recent study by the CDC (Center for Disease Control) presented some pretty alarming statistics with respect to prescription pain medications. These medications, also frequently referred to as Opioids, are linked to a growing and deadly epidemic of prescription painkiller abuse.  Some of the reported facts from the CDC study show that prescription pain killers were involved in 14,800 overdose deaths in 2008.  Combined, these total more deaths than resulted from cocaine and heroin use combined.  And these are just the deaths from overdose.  The misuse of these Opioids were responsible for more than 475,000 emergency room visits and countless treatment programs for substance abuse.

The CDC reported that for every death (14,800) there were:

  • 10    Treatment admissions for abuse;
  • 32   Emergency room visits for misuse or abuse;
  • 130 people who abuse or are dependent;
  • 825 people using painkillers for nonmedical reasons.

That is 12.2 million people in the US taking pain medication for nonmedical reasons in 2010.  To put that in perspective, that is roughly the population of the entire state of Illinois.

The State of Maine, relatively small by population standards, reported spending in excess of $100 million annually for treatment of painkiller addiction.   Some sources have estimated that nonmedical use of prescription painkillers costs health insurers up to $72.5 billion annually in direct health care costs.

The misusage numbers are alarming numbers in and of themselves.  But, when coupled with the cost to the various states for providing emergency care and treatment for addiction, there isn’t much question that tighter regulations are on the way.  We don’t have a crystal ball, but what we expect to see in the not too distant future are some combination of the following efforts to combat this problem:

  1. General practice physicians –  will be limited to prescribing Opioids to their patients for something along the order of one to two months.  Thereafter, it will be  necessary to see a medical specialist.
  2. Medical specialists – will be limited to prescribing Opioids only while the patient is undergoing active care.  Thereafter,  a patient will need to be referred to a Pain Management Specialist for longer term pain management, if it becomes necessary.
  3. Pain Management Specialists – have already have been working to curb the undesirable use of pain medications with efforts such as:
    • Using Pain Contracts, an agreement the patient signs that impresses upon them the importance of using the medication as intended.  The patient  promises to use the medication only as directed and won’t make the medication available for others to use.  Violation of the contract will result in the patient being booted from the pain management program.  From what we have seen in the past, there will likely be a zero tolerance policy for violators.  In combination with regulations requiring controlled access to medications, this will help prevent doctor shopping to find someone else to prescribe the medication.
    • Frequent and unannounced urine testing, to make sure the patient is not taking other unprescribed medication and is taking the prescribed medication.
    • A push toward alternative therapies. We’ve noted some medical specialists recently discussing the return of psychological behavior modification therapies for some pain patients.
  4. Pharmacies and controlled access – similar to what we see now if you want to purchase Pseudoephedrine. The states will operate a database and track an individual’s purchase of pain medications. Doing so should dramatically help to curtail anyone from using multiple physicians and pharmacies to obtain multiple prescriptions and acquiring Opioids to distribute to nonmedical users.

This is an issue that goes way beyond injured workers and the question of whether they took one too many pills or were able to skip a few. The broader problem is that an outrageous amount of pain medication is being used by people that don’t need it and aren’t supposed to be using it. Unfortunately, they are getting it from people that have had it prescribed to them but aren’t using it and doctors that shouldn’t be prescribing it at all. That is getting ready to stop.

Hanagan & McGovern in a southern Illinois personal injury and workers’ compensation law firm located in Mt. Vernon, Illinois and serving southern and central Illinois.  If you have questions on this, please give us a call or contact us.