Prescription painkiller abuse is the top addiction problem in Maine. Not only does the abuse have the potential to destroy the lives of those addicted to the pills, but its poison also radiates out through our small towns and rural areas. It manifests itself in frightening and sometimes deadly home invasions. It splits families apart, dooming the next generation to social problems. And it hamstrings businesses from growing, because the local work force is more interested in scoring the next pill than in showing up for work or learning new skills.
There is a desperate need for Maine law to address this serious problem. Rep. Jon Hinck, D-Portland, has proposed a bill that responds to prescription painkiller abuse with bold — some might say Draconian — steps. LD 1501, “An Act to Reduce Opioid Overprescription, Overuse and Abuse,” certainly would insert state law into the doctor-patient relationship, which some might see as violating a sacrosanct partnership. But given the severity of the abuse — Maine leads the nation in treatment for OxyContin addiction — such steps may be warranted. Maine’s admission rate to treatment programs is eight times the national average, according to Rep. Hinck.
LD 1501 proceeds from the premise that controlling access to the pills is within the scope of legal and medical authorities, unlike, say, cocaine, heroin or crystal meth, which are manufactured by and distributed on the black market. Painkillers such as OxyContin are manufactured legitimately, prescribed by physicians and distributed by highly regulated professionals working in carefully scrutinized businesses. If these pills cannot be kept out of the hands of abusers, there is no hope in controlling any substance.
The bill would mandate that health care providers obtain a history of a patient’s problems with pain, such as what caused it and the prognosis for treatment. The provider also would have to record the patient’s use of painkillers. This would help curb the “doctor shopping” tactic that addicts use.
Providers also would be required to create a pain-management plan and have the patient sign a written treatment agreement which would have to be shared with emergency department physicians. Perhaps the most intrusive element of the proposal is that urine samples could be required of patients.
Health care providers, not pharmacists or manufacturers, are the best hope for choking off the glut of pills. If this bill can persuasively be said to get providers to change their thinking and their methods in prescribing painkillers, it should move forward.
No one wants to see those suffering from painful, debilitating disease or injury or terminal illness be cut off from effective pain management. But given the volume of pills that have leaked out into the black market, it’s clear more pills are being prescribed than are needed. LD 1501 may be strong medicine, but it or another tough approach like it is needed.