Shortly before the holiday season, President Obama traveled to West Virginia
to discuss this country’s pain pill problem. While announcing a
new federal program to fight heroin and prescription drug abuse, he grimly
noted that more Americans now die from drug overdoses than car accidents.
The choice of West Virginia was no accident: it now has the highest rate
of drug overdose deaths in the country.
The pain pill problem is nothing new to Floridians. A few years ago, Florida
cracked down on what state officials called “pill mills.”
Florida had a reputation at the time for being a place where people could
go to get narcotics quickly and easily. The crackdown has been successful
in some respects, but it appears the problem has just moved to other states.
Insurance companies and others defending personal injury cases often portray
injured people as “pill heads” or “drug seekers.”
They argue that these people are just faking or exaggerating their injuries
to get more narcotics.
In reality, the situation is much more complicated. As lawyers for injured
people, we have seen cases where initially reasonable prescriptions for
pain medicine have sent people into a spiral of addiction. The people
who end up being hooked are usually not criminals or degenerates. Most
are normal people who didn’t realize they could become addicted
to drugs a doctor legally prescribed. Coming to grips with an accidental
addiction problem is horrifying and embarrassing for them.
Physicians also face real dilemmas in dealing with narcotic pain medication.
No one doubts that there are times when they should be prescribed, such
as immediately after a painful injury or surgery. But deciding how long
to prescribe those types of drugs, and when to stop or taper them off,
can be tricky for even the most dedicated medical professional. Compassionate
doctors struggle to balance pain relief for suffering patients with the
risks of getting them hooked.
Further complicating things, not all patients go through bouts of pain
and then recover. Many have diseases, conditions, or injuries which cause
them constant misery. Sometimes conservative treatment or surgery fails
to help, and a person is left with constant pain.
How best to treat these types of chronic pain patients is the subject of
great debate in the medical community. For many of them, narcotic pain
medications may be the only legally available ones which provide genuine
relief. A physician can cut off a patient’s medication because of
addiction concerns, but that can condemn them to suffering which makes
every day a brutal ordeal. There is also the risk that the patient will
turn to illegal drugs and “self medicate.” That is far more
dangerous and counterproductive than taking legal drugs under a physician’s care.
Lawmakers in both parties should realize that this is a complex problem.
Nonetheless, there are a few appropriate general observations to make.
First, those dependent on prescribed pain medication should not simply
be dismissed as drug addicts. In most cases, they should have a chance
to get treatment rather than being pushed into the criminal justice system.
Second, lawmakers should recognize that physicians who prescribe narcotics
to chronic pain patients may have legitimate reasons for doing so. Trying
to reduce intractable pain does not make a well-meaning doctor into a
There are few simple answers in the pain pill debate. However, it’s
good that a national conversation about the issue has begun.