Many Painkiller Abusers Use Doctors to Get Their Pills

Abusers of prescription painkillers increasingly turn to multiple doctors to gain their pills, according to research that indicates physicians need to be more vigilant when recommending the medications.

Of the 12 million people who abuse the medicines each year, two-thirds obtained the pills after about six months of use through prescriptions from one or more physicians or by buying them from friends, family or drug dealers, according to a study today in JAMA Internal Medicine. A second report in the journal showed a number of Tennessee users of painkillers got their drugs from at least four doctors and pharmacies each year.

Abuse of opioid painkillers kills more people each year than cocaine and heroin combined. The epidemic spurred U.S. legislation seeking to ban drugs that fail to resist tampering amid a push by the Food and Drug Administration to encourage treatments that are less likely to become addictive. Today’s findings show that doctors need to be more active in watching for abuses, said Christopher Jones of the FDA.

“People will see that there is a clinical side to this that has to be accounted for when looking at interventions and comprehensive policies to address the issue,” Jones, a senior adviser in the office of policy and planning at the FDA in Silver Spring, Maryland, said today in a telephone interview.

Screen Patients

Before prescribing these treatments, doctors should screen patients for the potential of abuse, look at drug-monitoring programs to make sure patients aren’t getting similar medicines or other controlled substances from other physicians and weigh the benefits and risks, said Jones, the lead author of the first study.

The researchers looked at data from the National Survey on Drug Use and Health from 2008 through 2011. They found that most of the 12 million people who took the painkillers for non-medical reasons were men and more than half had annual incomes of less than $50,000. The treatments include Purdue Pharma LP’s Oxycontin and Endo Health Solutions Inc.’s Opana.

Federal attempts to limit access to the painkillers has led to rising prices of the pills on the street, causing people to turn to drugs like heroin that cost less, according to U.S. drug officials last month. Heroin use increased 79 percent in the five years ended in 2012, with 669,000 people in the U.S. saying they had taken the drug, according to the National Survey on Drug Use and Health last year. Actor Philip Seymour Hoffman died in February from a toxic mix of drugs that included heroin and cocaine.

The second study released today found that about 2 million people in Tennessee, or almost one-third of the state’s population, filled one or more prescriptions for an opioid painkiller each year from 2007 to 2011. Increasing numbers of patients are getting the drugs from four or more physicians or four or more pharmacies each year, the authors said. And about half of those prescribed the pills who overdose could have been identified through prescription drug-monitoring programs before their deaths.

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