Maine’s Pill Problem

Posted Jan. 08, 2011, at 12:28 a.m.

It’s troubling, but not surprising. The news that Maine has the highest per capita treatment admission rate for opiates other than heroin in the nation is a call to action. The federal Substance Abuse and Mental Health Services Administration reports that treatment admissions for painkiller abuse in Maine has grown from 28 in 100,000 Mainers in 1998 to 386 admissions per 100,000 in 2008.

More treatment options are needed, and they must be tailored specifically to painkillers, this most pernicious of addictions. The ripple effects on the state’s social fabric and economy are too great to take a libertarian view.

As with other substance abuse problems, prescription painkiller addiction must be addressed on at least two fronts. Those prone to using the pills must be the focus of education and prevention efforts. And the supply side must be choked shut.

On the supply front, controlling availability of painkillers should be attainable. After all, unlike marijuana, which can be grown even in a northern climate like Maine’s, or methamphetamine, which is made in crude home labs, painkillers are produced by the pharmaceutical industry, prescribed by physicians and sold by licensed drugstores. There is no mystery as to how they enter the illicit market.

Laws might require physicians to report their prescription-writing history, and a regulatory board — perhaps staffed by retired physicians — should be created to intervene when opiates are prescribed more often than recommended. Patients could be required to renew prescriptions at more frequent intervals, thereby reducing the number of pills dispensed at a given time. Both measures would be inconveniences in the doctor-patient relationship, but the time has come for such steps.

In one way, it is encouraging that more Mainers are seeking treatment for painkiller addiction. But breaking the habit is a lot more difficult than quitting alcohol or cocaine. Synthetic opiates such as OxyContin essentially rewire the brain when they are abused, creating a profound and powerful pleasure response. Reversing that response is achieved only through long-term (which means expensive) treatment regimes. A federal surcharge on the companies that produce these abused painkillers could be used to underwrite treatment centers.

Last, an all-out education blitz about the horrors of opiate addiction must be undertaken. Young men — who often are the victims of the drugs — who have stopped using could be tapped to speak to middle school students about the risks. Parents, too, must be educated about the signs of abuse.

A generation of young adults numb to life’s pleasures, joys, struggles, challenges and pains is the terrible outcome if bold steps are not taken to combat this scourge.

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