Preventing addiction by stopping overprescribing


By Sen. Rob Portman



Portman


Look at your watch. In the next hour, five Americans will die of a drug overdose.

I’ve been working on the issue of drug abuse prevention for more than 20 years, but I have never seen anything like the epidemic of prescription drug and heroin addiction that is gripping our state right now.

Drug overdose deaths are at record levels in Ohio and across the country, surpassing car accidents and gun violence. According to the Centers for Disease Control and Prevention, more Americans died from drug overdoses in 2015 than died from AIDS in 1995, the worst year of that epidemic.

Nearly two-thirds of these deaths are due to overdoses of opioids: prescription painkillers, heroin, and synthetic forms of heroin like fentanyl.

And it’s getting worse, not better. In Ohio, overdose deaths increased by about 20 percent for the last two years in a row.

Usually the best way out of a crisis is to figure out how we got into it. In this case, a lot of it goes back to addictive prescription painkillers.

Think about this. Four out of five heroin addicts in Ohio started with prescription drugs. So if we want to deal with the heroin crisis, we’ve got to deal with prescription painkillers, too.

The United States uses more prescription painkillers than any other country in the world, and it’s not even close. According to a report last year from the American Society of Interventional Pain Physicians, we consume nearly 70 percent of the world’s painkillers, even though we’re not even five percent of the world’s population. For every American, there are on average 50 painkillers prescribed in this country every year.

The number of painkiller prescriptions tripled from 1991 to 2011, from 76 million to 219 million. At its height in 2012, there were more prescriptions for painkillers in Ohio than there were people in Ohio.

Fortunately we’ve had leadership at the state level from Governor Kasich, Lieutenant Governor Taylor, Attorney General DeWine, and the state legislature. And federal programs I’ve supported, including the High Intensity Drug Trafficking Area (HIDTA) program, have helped.

Through a number of initiatives, the number of painkiller prescriptions in Ohio have been reduced by 20 percent since they peaked in 2012.

But that number is still too high: according to the Ohio Board of Pharmacy, 631 million pain pills were prescribed to Ohioans last year. And every day nationwide, according to the Department of Health and Human Services, more than 650,000 prescription painkillers are dispensed and nearly 4,000 Americans abuse prescription painkillers for the first time.

So what should be done at the federal level?

First, the Administration should implement the Comprehensive Addiction and Recovery Act, or CARA, which I co-authored and which passed last summer. It’s an across-the-board modernization of our addiction policies, and part of what CARA does is deal with this underlying issue of overprescribing.

CARA changes the way the Veterans Affairs health system prescribes painkillers, adding more precautions to ensure that our veterans don’t become addicted. CARA also authorized new funding for prescription drug monitoring programs (PDMPs)—statewide electronic databases of prescriptions for certain potentially dangerous drugs.

This new funding is critical, but we’ve also got to make sure that these programs are actually being used—and used in a smart way.

That’s why I recently joined with Senator Amy Klobuchar to introduce new legislation called the Prescription Drug Monitoring Act, which requires any state receiving these funds to use these PDMPs the way they’re supposed to be used. Under our legislation, pharmacists would have to check the PDMP before they give out a potentially dangerous drug; doctors would also check with the PDMP before they prescribe a painkiller to ensure that they’re not duplicating prescriptions, and states would have to let doctors know if the PDMP sees any signs of a patient becoming addicted. The bill would also require states to share their PDMP information with each other. This is really important for states like Ohio where people can cross state lines to get prescriptions filled.

As a result of our bill, states would keep better track of prescription painkillers, keep them out of the wrong hands, and identify an addiction as early as possible so that it can be treated before it gets worse.

Our bill is a common-sense idea to ensure that taxpayer dollars are being used efficiently and to stop the over-prescribing that is behind so much of our opioid epidemic. That will prevent a lot of new addictions from starting in the first place, and save lives.

Portman
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By Sen. Rob Portman