Pill Mills and Opioid Epidemic

Pill mills in the U.S. have increasingly come under the scanner of late. The business of prescribing hundreds of pills without any medical need is usually run by unscrupulous doctors whose sole objective is profit. They are least bothered about the health of their patients. While drug dealers are rightfully prosecuted for causing the widespread mayhem, certain doctors too have contributed to the mess and the opioid overdose deaths. Dr. Hsiu-Ying “Lisa” Tseng became the first doctor in the United States to be convicted of murder for over-prescription that resulted in deaths of three patients. She was sentenced to 30 years’ life sentence. Since then more cases of doctor negligence have been reported from various parts of the country.

In 2010, Florida started regulating its “pain clinics” and doctors were prevented from dispensing medications from their offices. Reportedly, experts believed that this practice of writing prescriptions or distributing medications from private clinics was largely responsible for the spike in opioid prescriptions. Realizing that the opioid epidemic in the country is largely “doctor driven,” the Centers for Disease Control and Prevention (CDC), in 2016, released the guidelines for prescribing opioids to treat chronic pain.

Unfortunately, the success of the pill mill crackdown was short-lived. Even though in 2012, there was almost a 50 percent decrease in oxycodone overdose deaths in Florida, in the first half of 2016, there was a dramatic spike in the numbers of overdose cases. Oxycodone and hydrocodone were primarily responsible for the pill mill crises and it was estimated that on an average, 14 people were killed due to heroin and fentanyl overdoses. Even when the pill mill crisis was at its peak, the numbers attributed to overdosing were far less.

Heroin, fentanyl and carfentanil catch the fancy of drug users

Post the crackdown of pill mills, there has been an upsurge in the use of heroin, fentanyl and other synthetic opioids. Fentanyl is considered as one of the most potent drugs and has been classified as a Schedule II prescription drug. Primarily used for providing relief to those who have undergone a surgery and experience excruciating pain, the drug is to be used sparingly.

In many cases, users are aware of the risks attached and yet they are willing to experiment with the drugs at the cost of their life. So, while there was a suppression of pill mills, a significant majority were still addicted to drugs. Most opioid-based prescription pills are dangerously addictive. When they are not administered in a carefully monitored and time-bound manner, the likelihood of these triggering permanent changes in the brain’s reward centers is high.

Prescription drug abuse dilemma

For most doctors, the dilemma is how much to prescribe and whom to prescribe. While there are many who use prescription drugs for illegal purposes, some might be in genuine need of such drugs. Drugs classified as stimulants, benzodiazepines, anti-depressants, tranquilizers and opioid prescription painkillers are liable for misuse. The chances of addiction, and associated mental and physical health problems are quite high. Screening of those who have a high-risk potential is essential to prevent a fatal outcome. More awareness programs and emergency health care services to benefit the victims, their families and the public can be immensely helpful in curbing the opioid epidemic.