Medication Disposal

Opioid medications bind to the area of the brain that control pain and emotions, driving up levels of dopamine in the brain’s reward areas and producing an intense feeling of euphoria. As the brain becomes used to the feelings, it often takes more and more of the drug to produce the same levels of pain relief and well-being, leading to dependence and, later, addiction.

Opioids like Vicodin and Percocet are commonly prescribed to dull pain after medical procedures and to treat chronic pain. They also commonly languish in medicine cabinets, sometimes for years, making easy pickings for someone with an addiction.

What are consumers to do if they want a safe alternative to flushing unwanted drugs down the toilet or tossing them into the garbage? Drugs that are flushed can taint our rivers, lakes and water supplies. Drugs in the trash also may harm the environment, and can be found by children, pets – and even adults looking for a high.

National Prescription Drug Take-Back Day now occurs twice a year. But what can we do the rest of the year? There are a growing number of year-round disposal site in California, but the rest of the country is lagging behind.

To find take-back sites that definitely accept controlled drugs, check the federal Drug Enforcement Administration’s website at www.deadiversion.sudoj.gov/drug.disposal/ or call 800-882-9539.

The drugstore chain Walgreens has announced plans to install medication disposal bins at 500 stores nationwide. The effort began last month in California with 50 stores, says Walgreens spokesman Phil Caruso.

Primary Care Docs the Leading Prescribers of Narcotic Painkillers

Americans continue to be plagued by an epidemic of prescription narcotic painkiller abuse, and a new study finds primary care physicians (PCP) are by far the biggest prescribers of the drugs.

Researchers led by Dr. Jonathan Chen, of Stanford University, looked at data from 2013 Medicare Part D prescription drug coverage claims.  They focused on prescriptions for narcotic painkillers containing hydrocodone (like Vicodin), oxycodone (Oxycontin and Percocet), codeine and others in this class, known as opioids.

In sheer number of prescriptions written, the largest prescribers were PCPs.  Family practice doctors issued 15.3 million prescriptions, while internal medicine physicians issued 12.8 million, the researchers found.

The study also found nurse practitioners wrote 4.1 million prescriptions for narcotic painkillers while physician assistants ordered up 3.1 million.

Based on claims-per-prescriber, pain specialists led the way, followed by those in pain management, anesthesiology and physical medicine and rehabilitation, the researchers said.

There’s been a 10—fold increase in the abuse of narcotic painkillers in the United States over the past two decades, Chen noted in a Stanford news release.  Some experts have  suggested that small groups of high-volume prescribers and so-called “pill mills” are the main reasons for the narcotic painkiller overdose epidemic in the United States.

However, Chen’s team now believes that “high-volume prescribers are not alone responsible for the high national volume of opioid prescriptions,” and “efforts to curtain national opioid overprescribing must address a broad swath of prescribers to be effective.”

Almost 1 in 5 Americans Plagued by Constant Pain

The poll of roughly 35,000 American households reveals almost one-fifth of Americans experience daily crippling, chronic pain according to a new report published in the October issue of the Journal of Pain.

“I wasn’t particularly surprised by our findings,” said study author Jae Kennedy, a professor of health policy and administration at Washington State University in Spokane. “But I found it sobering that so many American adults are grappling with persistent pain.”

The study authors analyzed responses to a 2010 National Center for Health Statistics survey. Those who said they had experienced serious continual pain during the prior three months were the focus of the poll, rather than participants who said they had experienced short-term pain or pain that was intermittent or moderate in nature. Overall, 19 percent of the adults polled were deemed to have experienced “chronic” and severe daily pain.

That grouping did not, for the most part, include adults who said they struggled with arthritis or back and joint pain, as those people tended to say their pain was not constant and persistent, the study authors noted.

The chronic pain figure exceeded 18% among specific groups of respondents, including those between the ages of 60 and 60, women, those who said their health was fair or poor, those who were obese or overweight, and those who had been hospitalized in the prior year.

Kennedy suggested that for those experiencing chronic, crippling pain there are a variety of potential interventions including physical and occupational therapy, exercise, dietary changes, weight loss, massage and psychotherapy, alongside alternative interventions such as acupuncture, yoga and chiropractic services.
Medicines, including narcotic painkillers like hydrocodone, oxycodone and morphine, can also be helpful, but only if long-term use is avoided, Kennedy said.

“We are clearly overusing opioids [narcotics],” he noted. “The US consumes about 60% of the world’s opioid supply, and 99% of the hydrocodone supply. These medications are effective in the short term for managing postoperative pain, but long-term use often leads to dependency or addiction.”