Misconceptions About Prescription Drugs Endangering Users

On Monday, experts from a variety of fields met with the community to discuss the area's growing prescription drug abuse problem.

“More Americans now abuse prescription drugs than all illegal drugs combined,” Dr. Jim Mahanes said. “We're talking about heroine, cocaine, methamphetamine.”

Mahanes heads up the Prescription Drug Abuse Alliance, formerly known as the Narcotic Task Force, which brings together law enforcement, the medical field and other groups, to combat the issue.

“A few years ago, it became clear to us that there was an excessive demand and an overprescribing of prescription painkillers,” Mahanes said.

The group looked at statistics from the Coroner's Office in 2009.

“Out of the 36 accidental deaths we had in Pickens County, 25 of them were from unintentional drug overdoses,” Mahanes said. “And a lot of them had the 'holy trinity,' it's called, in their system of hydrocodone, Xanax and flexeril, which is a muscle relaxer. In that same year, there were only 17 motor vehicle accidents in Pickens County where people lost their lives.”

The group set some goals, including discovering the root cause of prescription drug abuse in this area.

“We want to educate our medical community to this problem, because we felt they didn't have a good understanding of this problem at all,” Mahanes said. “We wanted to develop some solutions to it. Last but not least, we wanted to inform and educate the public.”

That led to Monday night's Red Zone Rally, held at Pickens High School. Pickens and Oconee Counties have been described by Inspector General Patrick Maley as being in the “red zone” regarding the severity of prescription drug abuse in the state.

In 2010, the National Center for Disease Control declared that “prescription drug abuse was a national epidemic,” Mahanes said.

“That got everybody's attention,” he said.

That same year, 22,000 people died of drug overdoses nationally, Mahanes said.

“South Carolina happened to be 23^rd highest in the nation in overdose deaths per capita and also 23^rd highest in painkiller prescription per capita,” he said.

America accounts for only 4.6 percent of the world's population, but we consume 80 percent of the global supply of opioid painkillers and 99 percent of the global supply of hydrocodone,” Mahanes said. “Pretty incredible.”

Many states are now seeing the number of people killed by drug overdoses outnumber those killed in motor vehicle accidents annually.

The number of teens trying a painkiller for the first, for non-medical uses, now equals the number of teens trying cigarettes for the first time, Mahanes said.

“There were enough painkillers prescribed in the US in 2010 to medicate every American adult with five milligrams of hydrocodone every four hours for a month,” he said.

In 2010 and 2011, South Carolina ranked #11 on the list of unit doses – the number of pills - of hydrocodone sold.

“In 2010, it was 247 million,” Mahanes said. “In 2011, it was 262 million unit doses prescribed in South Carolina.”

A recent DrugFree.org study focused on teen misuse and abuse of prescription drugs, which is up 33 percent from 2008.

“It said parents' and caregivers' lax attitudes and behavior are linked to the findings in this study,” Mahanes said. “The most common place these drugs were found was in the family medicine cabinet.”

Many teens say their parents are more worried about street drugs than they are prescription drugs.

20 percent of teens surveyed in that study said they began abusing prescription drugs before the age of 14.

“27 percent stated they believed misuse and abuse of prescription drugs is safer than using street drugs,” Mahanes said.

There's a lot of blame to go around regarding this problem, he said.

Rogue clinics – some of them masquerading as pain management, “pill mills”, and unscrupulous practitioners are to blame, but they're not alone.

“Certainly licensed practitioners, the one that prescribe these medications, they're the suppliers for the demand that's out there,” Mahanes said. “The government also is involved – state and federal. And the public at large, because those are the ones demanding it and those are the ones taking it.”

In the 1990s, healthcare regulatory agencies began enforcing pain as a vital sign, he said.

“When you went into your doctor's office or the emergency room, not only would they take your blood pressure, they took your pulse and your temperature, how rapidly yo u were breathing, they also ask, 'What is your level of pain?'

The Joint Commission, which accredits hospitals, began requiring the use of pain scales – asking patients to rank their level of pain.

Physicians began to be educated on believing their patients' opinions on their pain and to “increase the dosage until the pain is controlled,” Mahanes said.

Patient satisfaction surveys began asking patients about their pain.

“'Was your pain controlled? Sometimes? Always? Never? Good? Bad?'” Mahanes said.

Patient satisfaction scores began to be linked to physician reimbursement.

“If the doctor was treating you well enough with pain medication, you gave them a good grade,” Mahanes said. “Are doctors sometimes more likely to over-treat? I think that answer should be obvious.”

Our society doesn't have much of a tolerance and discomfort anymore, he said.

“They believe pills should be taken for most ailments and sometimes normal bodily functions,” Mahanes said.

Drugs are overexposed on television, he said. Many people don't realize the danger that prescription pills can pose if abused or misused.

“It's from a doctor and it's FDA-approved, so it's got to be safe, right?” Mahanes said. “That's what people think.”