A rapidly growing epidemic of prescription drug abuse is threatening the United States, and yet doctors still don’t have an effective way to objectively measure pain, The Wall Street Journal reports. The majority of doctors simply ask patients to rate their discomfort on a scale of one to 10, or have them select a cartoon face that represents a similar expression to the level of pain they are feeling.
Joel Saper, Director of the Michigan Head Pain and Neurological Institute in Ann Arbor, told the newspaper, “We don’t have a pain-o-meter.” His estimate is that between 15 to 20 percent of patients seeking relief from discomfort either don’t have painful situations or have less serious ones than they say they do.
There are a variety of reasons why patients fake it; the majority of them are either addicted to prescription painkillers or want to illegally sell them, adding to the prescription drug abuse problem.
In patients who really suffer, the level of pain tolerance still varies. Effective pain medication management requires doctors to balance the problem of prescription painkiller abuse with the needs of patients in real pain.
Nearly 116 million Americans suffer from chronic pain. Roughly 28 percent of patients are affected by low back pain, making it the most common type of pain. Knee pain is second, affecting 20 percent, according to a new report by the Institute of Medicine called Relieving Pain in America.
Although it is nearly impossible for doctors to measure pain or to tell if a patient is merely faking their symptoms, 15 to 20 percent of all doctor visits in the United States involve an opioid prescription.
Patients who doctors believe are at risk of prescription drug abuse are asked to sign an opioid contract. This agreement establishes an understanding that the patient will only receive opioids from that doctor and only one pharmacy. The patient is also told that if their medication is lost, it will not be replaced. Stolen medication will only be replaced if the person brings a police report.
In the United States, more people abuse prescription drugs than cocaine, heroin, and Ecstasy combined. And hydrocodone, better known by its brand name, Vicodin, is the number 1 drug responsible for opioid addiction.
According to the Centers for Disease Control and Prevention, overdose deaths from painkillers have risen from less than 4,000 in 2000 to more than 11,000 in 2007. The Office of National Drug Control Policy also reports that opioid abuse is the second-leading cause of accidental death in the U.S., after car crashes.
Locally, states are helping with pain medication management by taking preventative measures against prescription drug abuse by utilizing prescription drug databases that allow doctors to check on whether patients are receiving similar drugs from other doctors in the state.
At the epicenter of this national problem, Florida is leading the battle against prescription drug abuse. Recently, Florida passed laws that will set the standard nationally by tightening regulations for pharmacies, increasing fines for doctors who overprescribe painkillers and establishing a prescription-drug monitoring database. Time will tell if Florida’s pain medication management plan can work. Stay tuned…