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COMMENTARY: Growth of pain medication abuse requires diverse solutions


Much more needs to be done about pain medication misuse and addiction. The problem's ugly facts came into sharper view this month when the Centers for Disease Control and Prevention released findings showing that prescription pain medications are killing more women than ever.

Almost 48,000 U.S. women died from prescription painkiller overdoses between 1999 and 2010, with the number of women dying having increased 400% during the period. And for every death, 30 women went to the emergency room due to misuse or abuse problems.

Women aren't alone here. But the CDC wanted to get the word out that while men are still more likely to die of prescription pain medication overdoses, the gender gap is closing. While female overdose fatalities rose 400%, prescription painkiller overdose deaths among men rose 265%.

Many of the deaths among men and women follow from drug-addiction problems that emerged after injuries treated legally with powerful narcotics.

The problem with opioid pain medications first came to my attention a couple of years ago when I heard two employers presenting at a conference. They described enlisting their pharmacy benefit managers and third-party administrators to identify doctors prescribing the addictive medications to their workers compensation claimants. Once those doctors are identified, they can be asked whether the drugs are absolutely necessary.

Since then, the workers comp industry has spread the word among doctors, regulators, employers, insurers, claims examiners and everyone else involved in the treatment of injured workers about the dangers of prescribing excessive painkillers and how to reverse the trend.

The widespread effort is warranted, and similar efforts outside the workers comp industry have included law enforcement cracking down on pill mills and doctors who flagrantly abuse their prescribing authority for profit.

Yet more can be done.

The same week the CDC released its report on women and the misuse of pain medications, CDC Director Dr. Tom Frieden told reporters that too many doctors are still prescribing powerful pain drugs developed for severe cancer pain and other major illnesses when physical therapy, exercise and other alternatives will do.

So there still is a need for doctors to talk to their patients about pain-treatment options that don't involve addictive prescriptions. Medical guidelines for prescribing painkillers also must be followed.

Other measures that would help include states establishing or improving prescription drug monitoring programs aimed at helping reduce painkiller abuse and diversion, while the federal government could do more to educate the public and medical providers.