Individual use of prescription opioids has increased four-fold since the mid-1990s, in part due to increased awareness of pain control for chronic conditions such as low back pain and fibromyalgia and a Joint Commission mandate that hospitals assess patients' pain as a "vital sign" along with their blood pressure and temperature. During the same timeframe, however, the number of people using these drugs recreationally, becoming addicted to them, and dying of overdoses has also shot up. Today, nearly three quarters of all fatal drug overdoses in the United States are due to prescription drugs -- far outnumbering deaths from cocaine and heroin combined, and often outpacing car accidents as the top cause of preventable deaths.
A Perspective piece published online today in the New England Journal of Medicine outlines a plan for an "ideal" prescription-drug monitoring program that would enable doctors, dentists, pharmacists, researchers and law enforcement officials to access real-time data on patients' prescription drug histories. The authors, medical toxicologists Jeanmarie Perrone, MD, an associate professor of Emergency Medicine in the Perelman School of Medicine at the University of Pennsylvania, and Lewis S. Nelson, MD, a professor of Emergency Medicine at the New York University School of Medicine, say that such programs would allow physicians to take better care of patients with legitimate pain issues as well as identify and intervene to help potential drug abusers, and cut the number of opioids in circulation for illegal sale.
"As the number of deaths associated with prescription-drug use surpasses the number of fatalities from motor-vehicle crashes in many states, we can learn from the success of auto-safety innovations that have mitigated mortality despite increased automobile use over the past three decades," the authors write. "We should initiate active safety measures to address the growing rates of illness and death associated with the pharmaceuticalization of the 21st century."
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