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Big Pharma Production Still High

Even though the government could choke off the supply of opioids that are ripping apart families and communities, characteristically our “fully committed” politicians and President Barack Obama signed a new law this spring that makes it more difficult for government to take action against the pharmaceutical industry that has flooded the market with so-called “safe” painkillers.

Opioids are intended to manage pain, but the stealth affect on the brain is an intense high that the brain craves long after the pain is gone. So, oxycodone, hydrocodone and others are not as safe as Big Pharma would have us believe.

The Ensuring Patient Access and Effective Drug Enforcement Act of 2016 allows companies accused of failing to report suspicious orders of dangerous drugs to submit a “corrective action plan” to persuade the U.S. Drug Enforcement Administration to postpone or abandon proceedings against them. The law also raises the bar for the DEA to temporarily suspend their licenses.

Shockingly, this comes at a time when nearly 2 million Americans either abused or were dependent on prescription opioid pain-relievers. With more than 18,000 opioid overdose deaths in 2014, drug overdoses surpassed car accidents as the leading accidental cause of deaths in the United States. More than 47,000 Americans died from drug overdoses overall, according to the U.S. Centers for Disease Control and Prevention.

Here’s the dilemma: As a culture, we have no tolerance for pain. In 2012 alone, physicians wrote more than 282 million prescriptions for opioids. This is more than enough to give every American adult their own bottle of pills.

Now we’ve put physicians in the role of deciding whether their patient is a drug addict or in real pain. With the pressure on physicians to see patients every seven minutes, I doubt the answer can be arrived at easily.

States have begun tackling the issue by limiting the amount of opioids that can be prescribed by physicians. In June, New York passed a law that limits initial prescriptions for acute pain to seven days, down from 30 days, with refills or renewals after further consultations. There are exceptions for chronic pain and hospice and palliative care. It also requires insurers to cover necessary inpatient services in their networks for detoxification and rehabilitation without pre-authorization or utilization review during the first 14 days of inpatient treatment.

But there’s a downside of limiting the prescriptions: Lots of people have legitimate pain and will now have to jump through burdensome hoops for refills. And others misusing opioids will move on to heroin, which is easily available and cheap.

New York state’s Prescription Monitoring Program was initiated in 2012 to allow doctors and other prescribers to search patients’ prescription drug histories on an electronic database. Forty-one states use a drug-monitoring program before prescribing opioid painkillers, sedatives or other harmful and addictive drugs. Many also share data.

Although the American Medical Society supports drug-tracking systems, many state medical societies have argued against mandatory requirements they say could interfere with patients’ privacy and legitimate pain needs.

Recently, the White House asked medical schools to sign a pledge requiring students to study federal guidelines for safe opioid prescribing before they graduate. In some schools, medical students are organizing their own training forums.

And then, in mid-July, in another effort to make prevention and treatment more widely available, Obama signed the Comprehensive Addiction and Recovery Act of 2016. But this legislation does not address the front-end problem.

The federal government could have triggered our nation’s rescue from this epidemic by cutting Big Pharma’s opioid production quota. But they didn’t. They kicked the can into the physician’s office. Again, Washington fiddles while 49 Americans die each day from opioid overdose.

Susan M. Mathews, Ph.D., has a master’s in bioethics from Union Graduate Collegeand Icahn School of Medicine at Mount Sinai.

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