The battle against the heroin epidemic should begin with the family doctor.
No, licensed physicians aren’t prescribing or providing heroin. But the terrible byproduct of frequent prescribing of legal, painkilling drugs called opioids is that vast numbers of people have experienced opioids’ ability to trigger the release of the neurotransmitter dopamine, causing intense pleasure. No surprise, then, that so many people, when their prescriptions end or even before, start looking for a cheaper way to get high. Heroin enters the picture.
Health and science reporter Jack Rodolico cited a startling statistic in a recent radio broadcast about the heroin scourge: In 2012, doctors wrote 259 million prescriptions for opioid pain medication, enough painkillers for every American to have a bottle. How did this happen? There’s been a gradual acceptance of prescribing painkillers, which traditionally were reserved primarily for end-of-life discomfort from cancer, for everything from back pain to osteoarthritis. Today Vicodin and Oxycontin are household names.
Sadly, people who take these prescribed drugs can get addicted through a single prescription, and getting clean can be hard. The Centers for Disease Control and Prevention reports that nearly 2 million Americans abused prescription painkillers in 2013. On average 44 people die daily from prescription painkiller overdose, and nearly 7,000 people are treated in ERs daily for using such drugs other than directed.
Communities and states should take steps to keep track of pain clinics, more effectively identifying fraudulent prescriptions and improving access to naloxone, the antidote to opioid overdose. Pennsylvania did so last year.
But at the core are physicians themselves, whose role includes sensible counseling as well as prescribing drugs. Doctors should encourage patients to consider time-worn alternatives to the opioids that are contributing so heavily to the scourge of heroin. It’s very possible that over-the-counter options as basic as aspirin or ibuprophen, properly used, could provide needed temporary relief from pain. True, they lack the “pleasure” punch. But they also do not pose the terrible and very real risk of opioid addiction.
