Marvin D. Seppala, M.D., is chief medical officer of Hazelden Foundation, based in Center City, Minn.
By Marvin D. Seppala
When the deaths caused by opiate addiction eclipse those caused by car accidents, it's time to take action. And that's what the U.S. Food and Drug Administration did Monday when it introduced new safety measures to reduce the risks associated with misuse of prescription painkillers (without interfering with their legitimate use for people in pain).
The measures require more than 20 manufacturers of extended-release and long-acting opioids to contribute funds toward education and training programs for doctors and consumers, helping them to weigh the benefits and risks of opioid therapy and providing information on the safe use and disposal of the medications.
At Hazelden, we see over and over again the deadly continuum of opioid addiction. It starts not on the mean streets but right at home in your own medicine cabinet: Painkillers left over from a tooth extraction or a hip replacement are free for the taking, and no one's looking or counting. Opioid addiction progresses rapidly, and a naive experimenter soon finds himself or herself in a frantic race to stave off the miserable withdrawal symptoms.
When the pills run out, heroin is the much cheaper and more powerful alternative. For example, it costs $40 for one OxyContin on the open market, and $20 to maintain a twice-daily heroin habit.
Users can't lower their own standards fast enough to keep up with the progression of the disease: Those who swore they'd never use a needle find themselves doing it anyway.
The numbers tell the tragic story: In 2008, more than 36,000 people in the United States died from drug overdoses, a number that has tripled since 1990 and one that has been fueled by prescription drugs. The numbers in our own backyard are equally alarming:
Dakota County prosecuted 40 heroin cases in 2011, compared with 22 in 2009.
Scott County prosecuted 37 heroin cases in 2011, compared with 10 in 2009.
In 2011, the Southwest Metro Drug Task Force intercepted a 4.4 pound package of black tar heroin, en route from California to Scott County.
The number of fatal heroin overdoses has nearly tripled in the Anoka/Hennepin/Ramsey county area, from 16 in 2010 to 46 in 2011.
There is effective treatment for opioid addiction. But we must all educate ourselves about this problem, and we must support prevention, education and monitoring efforts. The FDA deserves our applause for taking this action, even as we realize how much more needs to be done.
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