The Struggle Doctors Face when Prescribing Pain Medication

Recently, on NPR (National Public Radio), there was a program about the physician's role amidst the opioid epidemic. As more and more people are dying due to overdoses from prescription pain medication, doctors are getting more heat for giving out too many prescriptions. 

However, at one point, doctors were encouraged to give out these prescriptions. Influenced by pharmaceutical companies and their encouragement to prescribe their medication, doctors were offering pain medication to those who needed it in a more relaxed fashion. Yet, today, in the midst of an opioid epidemic, doctors have tightened the reigns and become more discerning. 

For instance, in program mentioned, Dr. Wanda Filer, president of the American Academy of Family Physicians, described her experience of seeing three patients needing pain medication. One of them she knew well and has been managing her pain with medication for a long time. Filer explained that this patient regularly gets tested, has a signed a contract, and has not shown signs of addiction or misuse.  She described another patient who had never been in her office before and who did not have any medical history with her. Filer chose not to prescribe this person any medication because of the risks of potential abuse. Filer also admitted that knowing what she knows today about prescription pain medication, she would have treated earlier patients with different, less addictive, medication. 

The active ingredient in prescription pain medication is an opiate. Common forms of opioids, in the form of painkillers, include oxycodone, hydrocodone, diphenoxylate, morphine, codeine, and methadone. Furthermore, heroin is an opioid making this illicit drug attractive to those who are addicted to prescription painkillers and who have run out of prescriptions.  The most commonly abused prescription drugs include Vicodin and Xanax.

According to the Centers for Disease Control and Prevention (CDC), approximately 19,000 people overdosed on prescription pain medication. And between 2012-2014, prescription pain medication has been a significant issue among teens and young adults in East Coast states, as well as in the Midwest. 

As the NPR program referenced, the CDC is soon to publish a set of guidelines for physicians to follow when prescribing pain medication. The problem that most doctors have is finding that balance between helping someone who has severe pain and who needs medication to manage that pain versus prescribing different medication to someone who might not be in pain long term and who might be more vulnerable to an addiction. It's a tricky balance with some people. The circumstances in each person's life can make it difficult to know exactly what to do.

Likely, however, doctors are going to err on the side of caution, prescribing less pain medication especially to those who show signs of potential abuse of the drugs. However, it should be noted that even someone who may not have a history of addiction nor signs of abuse might still end up with an addiction to prescription pain medication because of their addictive quality. Certainly, the current epidemic indicates that this a medical issue that has yet to find all the answers. 

If you or someone you know is addicted to prescription pain medication, contact a mental health provider for immediate support. Doing so can save a person's life!