Painkillers and Prescription Drugs 101

An expert panel put together by the Food & Drug Administration wants more training for doctors that prescribe heavy painkillers like morphine or oxycodone. The panel members don’t think current FDA requirements go far enough. They said both physicians and patients need to better understand and recognize the potential for, and actual abuse.

The FDA thinks mandatory training might be too onerous, since so many physicians throughout the US prescribe these types of drugs. The Associated Press noted that “opioid abuse …. is responsible for more fatal overdoses each year than heroin and cocaine combined.” That’s scary. Shouldn’t they be teaching more about this in medical school?

Training just seems like a smart idea. As a patient, I’d rather that my physician be a bit more burdened and ensure everyone’s health and safety. Stories abound about doctors that write an Rx for whatever the patient asks for – and may not be aware of potential narcotic abuse. On the flip side –I want to know that the scrip my doctor is writing for a really powerful painkiller is appropriate and that she really understands what the potential effects might occur, based on my health history, size, body mass, and any other prescription drugs I am taking.

Does she really know if this is the right strength, the correct number of pills, the optimal number of days to be on this med? Suppose a patient insists that she is still in pain after the original prescription is used up – will the doctor ask the right questions and assess potential dependency? Or in this hurry up, I’ve-only-got-5 -minutes-to-see-you health system, will the doc just write the prescription so he/she can move along to the next patient?

Opiates and other prescription drugs are also a serious problem on the road. A recent article in The New York Times talked about how police are pulling over drivers suspected of DUI. But these drivers are not drunk. Or even high on something illegal. They are on legitimate prescription painkillers. These are vexing cases for the police – since unlike alcohol, there’s not a single standard for what makes a person “impaired” in these cases. How a person reacts on a particular drug varies from person to person, and even from day to day, depending on what else, is mixed with it – no food, a lot of food, a glass of wine.

How to handle these “drugged” drivers is tricky. Some medications can stay in the body for days or even weeks. People legitimately need everything from back pain relief to allergy medication. Each med is different, and dosage can vary depending on the condition, the person’s age, or weight. So how does a local or state government set a consistent standard?

It’s easy to say don’t drive if you’re taking a prescription medication. But if that was the case, it would throw our economy into further shambles, since so many adults are on at least one drug for some ailment or another. “Use common sense” is a no-brainer, but the patient often can’t tell he or she is too impaired to be behind the wheel. And besides, too many people seem to be lacking common sense these days (but that’s for another blog post).

So what do you think should be done? Share your ideas.

4 comments / Add your comment below

  1. The driving tests are the key, not whether the substance is legal or not (alcohol is a legal substance; driving under the influence is not.) A person who is driving in an unsafe manner, no matter the cause, should be stopped. And while this has nothing to do with your topic, exactly, the same applies to the elderly whose reflexes are slow or whose mental status is impaired from brain decline. I wish they would re-test seniors for driving issues!

    1. Thanks for the comment, Alison. I agree that people should be stopped if they are driving erratically for any reason. I think the issue is the ability to come up with some kind of standardization for “impaired.”

      People don’t always realize that taking something as simple as an allergy med can endanger others’ lives. Unfortunately most of the country is so car-centric that it becomes a choice between getting to work and their health status.

      I also support a re-test of senior drivers; maybe all of us should have a refresher class every 10 years or so after we reach a certain age.

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