Regulating Painkillers: A Prescription for Smarter Drug Policy

Tuesday, July 13, 2010
Hippocratic Symbol

The use and abuse of prescription opiates (powerful pain killers, such as Vicodin® and OxyContin®) has been steadily increasing in recent years. 1 in 5 adolescents and 1 in 10 adults are prescribed an opiate medication each year. Many of these drugs will be used illicitly by those who do not have a prescription. In 2008, prescription opiate abuse accounted for 20% of all publicly funded treatment admissions, ahead of marijuana and cocaine.

A variety of solutions have been offered for dealing with the prescription opiate problem. Better education for patients and healthcare professionals, tighter regulations for how and when they can be used, and disposal programs for unused medications. Notably absent from these solutions is one we commonly rely on in the United States; total prohibition via criminal enforcement. Thank goodness!

Washington state currently is confronting this serious rise in prescription drug abuse.  In 2008, 12% of Washington high school seniors reported using prescription pain relievers to get high in the past 30 days. We also have one of the highest rates of adult illicit use of prescription pain relievers in the nation.

In other words, it is a significant problem that requires serious solutions. House Bill 2876, which passed in the Washington legislature this spring, is an attempt to provide just that. 

The bill directs five health boards and commissions to adopt rules concerning management of chronic, non-cancer pain. I’ll save my thoughts on the merits of this specific piece of legislation and its subsequent rule-making for a future post, as some patient advocacy groups have expressed concerns that HB 2876 may limit patient access to effective pain medications. Aside from these concerns, however, the mere fact that our legislature is dealing with this issue via regulation instead of criminalization is commendable.  

The general public recognizes that the War on Drugs has been a colossal failure (74% of people think so, according to a commonly cited Pew poll). Put bluntly, criminalizing addiction is ineffective and costly for individuals and society. It is time that we come up with new strategies for the challenges of substance abuse. Perhaps it is time for a paradigm shift. Portugal did just that when it decriminalized the use of all drugs in 2001. This strategy has worked; usage rates have not increased and thousands of individuals have avoided being labeled criminals.

By focusing on the health of the individual and getting the criminal justice system out of the picture, we can have a smarter, more effective, and compassionate policy for dealing with addiction. Dealing with the prescription opiate problem via smart regulation is a step in the right direction. I hope lawmakers will continue to utilize health experts when confronting substance abuse issues. Continued overreliance on the criminal justice system may be politically expedient, but it is without a doubt bad policy.

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