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Pain meds: A fatal attraction

Addiction

Overdoses from prescription painkillers take the lives of more than 40,000 Americans each year. It’s a growing epidemic that the Centers for Disease Control and Prevention calls “the worst drug crisis in U.S. history,” and it’s a growing concern in Hawai‘i, too.

“Since 2007, more people in Hawai‘i have died each year from drug overdoses than from fatal motor vehicle accidents, and opioid pain relievers contribute to more than a third of those deaths,” notes William Scruggs, M.D., an emergency physician on staff at Castle Medical Center who is helping to develop legislation to protect patients from prescription drug addiction and abuse. “Emergency rooms here have been seeing a gradual increase in overdose patients, but fortunately most of the overdoses aren’t lethal.”

The biggest culprits are prescription painkillers called opioids: hydrocodone (like Vicodin), oxycodone (OxyContin) and oxymorphone (Opana).

“These drugs are extremely addictive, even when patients are placed on these medications for just a few days,” Dr. Scruggs explains. “And they aren’t necessarily the best way to manage pain. Many over-the-counter pain medicines like Tylenol, Motrin, or Naproxen are as effective, or more effective, than opioids, without the potential for addiction. Massage therapy, acupuncture, and chiropractic manipulation can also help with pain management.”

Dr. Scruggs believes that a large part of today’s prescription drug problem is the result of legitimate efforts to treat pain. There has been a dramatic increase in the use of these medications to treat chronic pain.

“Since the 1990s, pain pills have been perceived as a cure-all panacea; physicians were trained to prescribe opioids—for everyone with pain,” he says. “Today we’re finding that these painkillers are being prescribed too often in ways that may be dangerous for patients. It’s important that we improve the ways in which both patients and physicians manage pain—and their expectations of pain relief.”

Groups like the Hawai‘i Chapter of the American College of Emergency Physicians, of which Dr. Scruggs is now president, have developed guidelines to help their peers better understand the risks of opioid medications and identify patients with a higher risk of addiction.

Who’s at risk?

These factors raise the risk of prescription abuse, addiction and overdose:

  • Chronic opioid therapy or high daily dosages of prescription painkillers
  • Combining overlapping prescriptions from multiple providers or pharmacies
  • Having mental illness or a history of alcohol or substance abuse.

Avoid addiction

Prescription abuse and addiction does not discriminate based on age, ethnicity, social status, or wealth. It’s a problem that can lurk in anyone’s medicine cabinet. These tips can help you and your loved ones avoid the risk of addiction:

  • Try other pain control methods before taking opioid painkillers.
  • If you absolutely need to take prescription painkillers, take only enough to get through your pain episode, and use them only as instructed by your doctor.
  • Store prescription painkillers in a safe place, out of reach of others.
  • Properly dispose of unused medications, for your own safety and the safety of others. Hawai‘i has a program to help you safely dispose of medicine. Call 837-8470 to get the details.
  • Help prevent misuse and abuse by not selling or sharing prescription painkillers, and never use another person’s prescription painkillers.