Editorial Board

A Prescription to End Painkiller Abuse

In proposing to strengthen the rules on prescribing opioid painkillers, the Food and Drug Administration is certainly making the right call. Tighter restrictions are needed to stem the fast-growing crisis of addiction and overdose from drugs containing the narcotic hydrocodone.

By limiting prescriptions to a three-month supply and not allowing doctors to phone them in, the new rules should help lower the number of pills in circulation that end up being taken recreationally -- often by a patient’s family members or friends.

These drugs are too big a problem, however, to be solved by this one change. In 2010, the U.S. had 16,651 fatal overdoses from opioid painkillers, triple the number in 1990 and accounting for three-fourths of all drug overdose deaths. More than 12 million Americans reported abusing the drugs that year.

What’s also needed is better monitoring of all prescriptions through electronic databases, so that doctors and pharmacists can tell whether a patient is looking to fill prescriptions for hydrocodone-combination drugs from more than one doctor. Almost every state has a prescription-drug database, but many are voluntary, or they don’t require that pharmacists update them instantly -- allowing patients to submit multiple prescriptions before anyone sees the problem. Some states allow only police to monitor the databases, so a doctor can’t know whether a new patient has painkillers already.

New York state has a strong model: It requires doctors to check the database before issuing any new prescription, and it has widened access to its Internet System for Tracking Over-Prescribing, or I-STOP, allowing doctors’ front-office staff to do searches. New York has also established a network of drop boxes at sheriff’s offices and police stations where people can dispose of unused pills before they end up in the hands of recreational users.

No one wants to ban prescription painkillers; they’re too essential to treating people’s real physical pain. Well-designed databases help doctors make the best use of these drugs without also enabling addiction and abuse.