Tackling the Prescription Drug Epidemic: Four Ways We Can Fight Back
By State Representative Sean Scanlon
Last year, as a candidate for the Connecticut House of Representatives, I spent nearly every single day between announcing my candidacy in April and the election in November knocking on doors in my suburban district.
To some people, this is the worst part of a campaign. But to me, it was by far the best part. Each day I went out and not only listened to the concerns of people I hoped to represent but also learned an incredible amount about issues I had never even heard of before ringing their doorbell.
One issue I heard quite a bit about was prescription drug abuse and after being elected and taking office, I decided to try and do something about it as a new legislator.
When you think of the word “epidemic,” what probably comes to mind is a fast-spreading virus out of a Hollywood movie. For several weeks last fall the United States was consumed with fear of an Ebola outbreak in which less than five people actually tested positive for the virus.
Prescription drug abuse, on the other hand, is an epidemic you don’t hear about but one that is far deadlier than Ebola.
Since 1990, death by drug overdose has tripled in our society. According to the Centers for Disease Control, 3 out of 4 overdose deaths in the United States are caused by prescription drugs (that’s more than deaths from cocaine and heroin overdoses combined).
Each day in this country, an estimated 120 people die from prescription drug overdose and another 6,700 are treated in emergency rooms for overdose (CDC).
Here in Connecticut, more people between the ages of 20 and 64 die from prescription drug overdoses than from car accidents.
Since the above statistics were reported in 2010, the problem has only gotten worse. According to the Connecticut Department of Public Health, 490 Connecticut residents died from drug overdoses in 2013, a nearly 40% jump over 2012.
The CDC estimates that 1 in 20 people in the United States age 12 or older reported using prescription drugs for non-medical reasons in 2010.
So what is causing this?
Many experts believe one of the biggest driving forces behind abuse of prescription drugs is the sheer volume of drugs available in society. Almost all prescription drugs used for non-medical purposes originate from legitimate prescriptions; very few actually enter the market through pharmacy theft.
As the chart above shows, just about 60% of the drugs come from a friend or relative either with that persons permission or without their knowledge (ex. stolen from a medicine cabinet of a friend of loved one).
When I met recently with the D.A.Y. Initiative — a group of parents and students in my hometown of Guilford looking to fight drug and alcohol abuse among young people — I asked the students why they thought prescription drug use was so prevalent among young people.
One student informed me that many of her peers assume that because someone they love or know was originally prescribed the drugs by a doctor, they couldn’t possibly be as bad for you as other illegal drugs like cocaine, heroin, or molly.
I realized in doing my research and talking to people actively working to address this issue that in order to fight back, we need to go beyond just educating people about the serious risks associated with using and abusing these drugs. We needed to fight back against the root cause of the problem by reducing the number of drugs in our society in general.
That’s why I decided to make the first bill I introduced as a State Representative about trying to address this issue.
Step One: Teach doctors, not just the public, on the dangers
We like to think that doctors know everything about everything there is to know about medicine. But, as one doctor in this field explained to me recently, medicine is a constantly evolving field; what a medical student learns today about prescription drugs is quite different than what your primary care physician learned twenty years ago.
In Connecticut, doctors are required to take a certain number of Continuing Medical Education (CME) courses in order to renew their license to practice medicine. Most doctors take CME courses that are relevant to the type of medicine they practice but all doctors are required to take at least one course in the following issue areas:
(A) Infectious diseases, including, but not limited to, acquired immune deficiency syndrome and human immunodeficiency virus, (B) risk management, (C) sexual assault, (D) domestic violence, (E) cultural competency, and (F) behavioral health.
My bill would add a seventh option — a CME course on prescription drug abuse and prevention.
Step Two and Three: Require doctors to register for and actually use the system created to stop prescription drug abuse
Almost every state in the United States has what’s called a Prescription Drug Monitoring Program (PDMP). The goal of this database is so that before a prescriber writes someone a prescription they can see if the patient has also been to several other doctors asking for the same drug.
In 2013, Governor Malloy signed Connecticut Public Act 13–172 into law which required prescribers to register for the PDMP.
The problem is that of the 26,000 prescribers in the state, only about 9,000 have actually registered for the PDMP as of last October.
My bill would mandate that in order to renew their license, a doctor would be required to have registered for the PDMP.
It would also require that, once registered, they actually use the PDMP or face loss of their license during their next renewal if they had not been actively using the system.
An additional positive step to take after these requirements are in place would be to have the Department of Public Health put together a professional expert group to audit the state’s largest prescribers. This group would contact said large prescribers to see why their volume was larger than the average prescriber in a given year and then work with them to explore ways in which that prescriber might cut back on the number of prescriptions they write.
Step Four: Give the public a convenient way to give back unused drugs
Data shows that over half of the drugs used for non-medical purposes come from family or friends who have excess drugs stemming from an original medical prescription. Think of a senior recovering from surgery who may take four or five pain pills only to have fifteen or twenty sitting in the medicine cabinet.
The problem is that most people don’t know what to do with excess drugs once they are finished with them.
Connecticut has a little-known program called the Medication Drop Box Program which provides funding for local police departments to purchase and install drug “take back” boxes inside their stations. Currently only 45 towns have these boxes and the average person doesn’t know they exist or frequent their local police station unless it’s an emergency to see that they are there.
One place people do frequent on a regular basis is their local pharmacy, especially when it comes to picking up prescriptions.
My bill would require that pharmacies take back any unused or unwanted prescription drugs. This way, the next time someone goes to pick up a new prescription they can simply return their old one at a convenient location instead of having to go through an elaborate process to destroy them or simply leaving them at home where they become accessible to those looking to abuse them. These pharmacies know how to properly destory these drugs and do it all the time for their expired stock.
In the coming weeks, the General Assembly’s Public Health committee will hold a hearing on my bill. Several of my colleagues have proposed similar pieces of legislation and just today Governor Malloy announced that he plans to address prescription drug abuse during his budget address next week.
As the legislative session continues and this important issue comes up for debate, I hope you will provide me with any feedback, suggestions, or comments you might have on my four ideas by emailing me at email@example.com.
My hope is that, together with my colleagues, we can make progress in addressing this crucial issue during this year’s legislative session. We cannot afford to wait much longer.