What do you think of when you hear the words “drug overdose”? If you’re like most people, you probably imagine scenes straight out of Traffic or Pulp Fiction: illegal drugs smuggled in from abroad, gritty urban street corners and paraphernalia spread around dirty bathrooms. While injection drug use in urban areas is still a big public health concern in the United States, the general problem of drug overdose has seen a dramatic shift, both in severity and demographics.
The number of overdose deaths has risen five-fold since 1990 and is now at the highest level ever recorded. Drug overdose is now the second leading cause of injury death nationwide, and the leading cause in more than a dozen states. The majority of these overdose deaths are due not to street drugs, but to prescription medications, which are now responsible for more overdoses than heroin and cocaine combined.
This dramatic increase in prescription drug deaths probably has a number of causes. One is simply that many more prescriptions are being written for powerful painkillers, and those prescriptions tend to be for higher doses. Some of these prescriptions come from “pill mills” – physicians with storefront offices willing to prescribe powerful painkillers to practically anybody who walks through the door, and to people misusing legitimately obtained prescriptions. But many are the unfortunate result of doctors and patients who are poorly informed about the medications they are prescribing and taking.
On April 19 the Office of National Drug Control Policy announced a new push to address the growing overdose epidemic. The document refers to prescription drug misuse as “the nation’s fastest-growing drug problem” and lays out a four part plan to address it. The report’s most notable recommendation is that all prescribers be required to undergo training before they are permitted to prescribe powerful drugs. According to “Drug Czar” Gil Kerlikowske, “the White House is absolutely committed to legislation that will make prescriber education mandatory.”
The report also supports the scale-up of Prescription Drug Monitoring Programs (PDMPs), electronic databases that track the pharmacy dispensing of drugs with abuse potential and make those data available to medical professionals and (in some circumstances) law enforcement officials. Thirty-four states currently operate PDMPs, but it is not clear how well they work. The report also recommends steps to increase proper disposal of prescription drugs, as well as stepped-up law enforcement. The overall goal is to achieve a 15 percent reduction in non-medical use of prescription drugs within 5 years.
While it is not clear whether the steps outlined in the report will lead to this goal, it is refreshing to see a plan that focuses on public health as the key mechanism to address the public health problem of drug overdose.
This information was developed by Corey Davis, staff attorney, for the Network for Public Health Law – Southeastern Region at National Health Law Program.
The Network for Public Health Law provides information and technical assistance on issues related to public health. The legal information and assistance provided in this document does not constitute legal advice or legal representation. For legal advice, readers should consult a lawyer in their state.