“Overdosed” – Pittsburgh Post-Gazette Features Doctor Prescribing Expose
The Pittsburgh Post-Gazette is currently featuring an investigative series entitled Overdosed, which chronicles a six-month investigation of doctors’ painkiller prescribing misconduct among seven states along Appalachia. These states include Pennsylvania, Kentucky, Ohio, West Virginia, Maryland, Virginia, and Tennessee.
From 2011-2015, 608 doctors have been disciplined by state medical boards, including the Pennsylvania Board of Medicine and Board Osteopathic Medicine. The series aimed to direct blame to doctors who have been liberally prescribing powerful painkillers (opioids), as well as regulatory systems which do not have the resources to respond immediately or effectively.
Included in the investigation are a number of specific physicians, who prescribed opioid drugs to those who were known addicts – even those who did not have serious pain. The Post-Gazette analyzed over 4,200 actions taken between 2011-2015 by medical boards in all seven states that include most of Appalachia.
Despite warnings about the addictive nature of painkillers such as oxycodone, literally hundreds of physicians throughout Appalachia (one of the most opioid-addicted areas of the country) continued to prescribe the drugs haphazardly.
Thus, unwittingly contributing to a drug epidemic which also now includes street drugs such as heroin.
Potent painkillers were prescribed for varying amounts of pain, including wisdom tooth removal and sunburn. This, despite knowing that patients were slinging their pills on the street for high dollars.
Insurers and pharmacies simply looked the other way, as did physicians when patients’ family members and friends asked them to address the patient’s addiction to the prescription drugs.
Van Ingram, Director, Office of Drug Control Policy (Kentucky):
“In Appalachia, there was definitely a pill culture that overtook the whole region. We’ve lost a generation, really, to this disease.”
Successes and Failures
According to the Post-Gazette and Overdosed, Kentucky was the only state in the area which took swift action and managed to mitigate the painkiller prescribing trend.
Kentucky’s painkiller epidemic led to tough crackdowns against doctors. Twelve of every 1,000 doctors were disciplined for overprescribing narcotics from 2011-2015. Some were even charged as drug dealers in federal court. 2015.
However, other states, including Pennsylvania, were slower to respond. The other states studied by the Post-Gazette all saw increased in overdose deaths for prescription opioids and heroin.
Painkiller prescribing in Pennsylvania decreased by only 2.3% from 2012-2014, which was the smallest drop among all the Appalachian states.
The Post-Gazette reported that Pennsylvania’s medical licensing boards currently do not have access to data on the prescribing practices of individual physicians and have disciplined far fewer doctors.
By 2012, in several Appalachian states (West Virginia, Tennessee and Kentucky) the number of opioid prescriptions written yearly had exceeded the total population.
Notably, however, In all seven states, drug prescribing declined by 2014.
Some states (i.e. Kentucky and Tennessee) have made prescribing guidelines official – which means doctors can be disciplined or sued if they do not abide. In Kentucky, doctors are now required to check a patient’s drug prescribing/addiction history before prescribing narcotic painkillers. They also must take 4.5 hours of classes on prescribing every two years.
Pennsylvania’s medical boards have not voted on whether to endorse guidelines, but that may be addressed this upcoming summer.
The Center for Disease Control and Prevention‘s new prescribing guidelines, finalized in March, encourage doctors to seek other options before turning to opioid painkillers.
The Overall Epidemic by the CDC
According to the Centers for Disease Control and Prevention (CDC), there was no change in amount of pain Americans have reported to hospitals – however, the number of opioids used quadrupled from 1999-2014.
There were over 47,000 drug overdose fatalities nationwide in 2014, and over 28,000 involved opioids, heroin or both. The CDC further states that 2 million Americans now abuse or are addicted to opioid painkillers..
It details many personal tragedies of those affected, as well as the practices of some doctors who were heavily investigated and found to be misprescribing.
There are also moments of detraction, in which apologists reiterate how these medicines were once touted as “safe” and heavily marketed to doctors.
Many of these doctors may have been doing what was expected of them at the time. Moreover, the rush of prescriptions came after serious complaints that doctors and the health care industry in this country were under-treating pain.
There is far more information available from the Post-Gazette that is summarized here. Overdosed is a close look at the practice of prescribing opioids and its effects on addicts and families. Reported by Rich Lord, J. Brady McCollough, and Adam Smeltz.
~ G. Nathalee Serrels, M.A., Psychology
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