It is no secret that Maine has an enormous problem with prescription drug abuse. In fact, Maine has the nation’s highest rate of residents seeking treatment for pain-pill addiction. We’re all paying the price in higher crime and incarceration rates, higher health care costs and wasted human potential.
Finally, there’s going to be some action.
In February, Gov. Paul LePage and Attorney General William Schneider created the Maine Prescription Drug Abuse Task Force. The formation of the group followed a “drug summit” last year, which addressed the problem with regard to drug death rates, impaired driving, hospital admissions, pharmacy robberies, drug arrests and other symptoms of this growing scourge.
Overall, the goal is to bring a more aggressive and coordinated approach to the situation.
The 17-member task force includes medical and law enforcement professionals, addiction specialists and pharmaceutical experts. As the sole state legislator on the task force and a former drug counselor, I am impressed with the energy and focus that have marked our early efforts. This is a no-nonsense group that wants to make a difference.
The drugs we’re talking about are opioids used for the management of chronic, noncancer pain, primarily oxycodone and methadone. Up until about 30 years ago, doctors were taught that these drugs were highly addictive. That attitude changed in the 1980s when medical literature suggested that true addiction rates were quite low. Opioid painkillers gradually became the drugs of choice for doctors dealing with patients suffering chronic pain.
As it turned out, opioids were indeed highly addictive. In recent years, we have seen a shift in the drugs leading to addiction in this country from heroin and cocaine to pain medications. Many well-meaning prescribers were misled into believing that good pain management equals opioids. Meanwhile, these drugs have proliferated, and abuse in Maine has emerged as a full-blown crisis.
Consider the following points:
• Maine is one of the top three states in the nation in terms of increase in pharmacy robberies over the past year.
• In 2010, abuse of pharmaceutical and illicit drugs, either alone or in combination, was responsible for 179 deaths. In the last decade, about 1,400 Maine residents have died from overdoses or abuse of prescription drugs, including oxycodone and methadone. Drug-related deaths now exceed traffic accident fatalities in Maine.
• Some of the most tragic stories involve newborns. In 2010 alone, more than 500 babies born in Maine entered the world drug dependent. That was an increase from 165 drug-dependent newborns in 2005 and 464 in 2008. Most of these babies were born methadone dependent.
• According to Maine law enforcement agencies, prescription drugs are the cause of 32 percent of property crimes and 27 percent of violent crimes — the highest rates in the country.
Clearly, the situation is alarming and demands action, but it’s a complex problem that must be approached responsibly. The task force has identified four main areas as practical and feasible.
First, we will develop a long-term controlled substance disposal program. Maine has led efforts to collect and dispose of unused prescription drugs to prevent abuse, but disposal restrictions have made the program expensive.
This issue must be addressed to get unused drugs out of medicine cabinets and kept away from high school-age children and addicts.
Second, we will develop an education campaign for both community education and prescriber training. This campaign will educate the public on pain and addiction as well as expectations for successful treatment of pain with opiates, including the risks, proper use and proper disposal.
Third, we will review the Prescription Monitoring Program and recommend improvements to maximize its use and effectiveness. A report or impact assessment will be submitted to the Substance Abuse Services Commission by next December.
Lastly, we will implement a diversion alert program that provides prescribers with drug crime information from local law enforcement to assist in determining whether patients are legitimately in need of controlled substance prescriptions.
Members of the task force will report every six months to the governor, the attorney general, the commissioner of public safety, the commissioner of environmental protection and the Legislature.
These initiatives by themselves will not eliminate the problem of prescription drug abuse, but they mark a solid first step in gaining control of the problem. The toll in human wreckage, health care expenditures, addiction, crime and misery is more than we can or should tolerate.
Rep. Susan Morissette, R-Winslow, serves on the Criminal Justice and Public Safety Committee and the Insurance and Financial Services Committee. She is a member of the Prescription Drug Abuse Task Force.
It’s interesting to me that the problem is always framed as one of ‘prescription drug abuse’ and not one of ‘sloppy prescribing practices’. These drugs are regulated for a reason. Without sloppy docs, people wouldn’t have access to the pills. A big part of the solution is making prescribers more accountable for their work. When is the last time you read about a Maine doctor being investigated for overprescribing?
actually, sometimes a doctor is prescribing, but then the patient is going to one er, then another Er, then another ER, and they have what seem like legitimate complaints. These drug abusers are, afterall, good at what they do. The big issue here is that when someone goes to an ER, they, by law, cannot be turned away, because what if it truly was a life or death emergency, or they aren’t drug seekers. It is very hard to tell. The ER doctors try to look back in their records to make sure there isn’t a record of this happening repeatedly at their facility, but if this person is spreading it out, then it is harder to track. The ER doctors can call the PCP, but if the person claims they don’t have one, or sometimes its hard to get in touch with the PCP, then they can’t get all the information they need. They can also check the PMP (prescription monitoring program ) but at the ER, things are moving so fast, that this is very hard to do. communication is the key here. If the patient gives the hospital the correct PCP, then ideally the ER note goes to their PCP shortly after the visit, then the PCP will see what was done, and if this patient is doing this repeatedly, or, has a narcotic contract, they will from that point on, be denied narcotics from their PCP because of breach of contract. The prescriber realizes that they are at risk and will not let this patient continue to recieve drugs from multiple places. There is also a program through MaineCare if the patient is a mainecare patient that if the pcp enrolls the patient, the patient can only get scripts from their PCP or providers that have been listed as okay to prescribe (such as a psychiatrist that is seeing the patient and the PCP notifies mainecare of this). If the patient tries to get a prescription filled by another provider than who is listed through the program, it will be denied until the PCP has approved it. They also can only get prescriptions filled at one pharmacy. This puts a stop to ER surfing. So, as you can see, doctors, or most of them, can and will try to put a stop to any noticed drug addiction or drug seeking behavior. They do not want to lose their license and they can. The blame falls in the hands of the patient. They are the ones who get the scripts filled, who go and make the complaints to multiple providers.
Many doctors’ offices make reminder calls the day before an appointment. The reminder call should include a request for patients to clean out their medicine cabinets and return old, unused medications to the doctor at the appointment.
where do I sign up to help! It’s about time these issues were addressed……