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Position Paper on Prescription Drug Overdose

Prescription drugs for pain relief play an important role in pain management for patients
that have had trauma, surgery, or have chronic illness. The most common of these prescription
drugs for pain management in many developed countries are opioids (Wilkerson et al., 2016).
Opioids consist of various types of pain-relieving drugs that range from mild to powerful pain
killers (Wilkerson et al., 2016). While generally effective in controlling acute pain, they have a
huge risk for addiction and overdose by users which leads to severe health consequences. Indeed,
the misuse of opioid drugs has become so widespread and the consequences so dire that it has
become one of the greatest health problems in the United States. To solve this problem, there is
need for concerted efforts involving the government, drug manufacturers, healthcare providers,
and all bodies and organizations involved in public health promotion.
Scale of the problem in the USA
When one examines how big a health problem overdosing on prescription drugs is in the
USA, it is easy to assume that the problem has always been there since pain killers are not a
recent invention. This is not the case. The problem of prescription drugs overdose and addiction
began in the US in the late 1990s (Jalal et al., 2018). With statistics showing that around a third
of Americans suffered from chronic pain, the government, in partnership with drug
manufacturers saw increased availability of strong pain killers as a possible solution to the
problem (Jalal et al., 2018). Healthcare providers, however, were worried that the painkillers
would be addictive to patients and would, therefore, likely lead another health crisis. Their
worries were assuaged when the drug manufacturers assured them that the painkillers would not

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lead to addiction (Jalal et al., 2018). Thus, began two decades of extensive use of prescription
drugs by Americans.
This extensive use of prescription drugs has had a devastating impact on the health of the
users. Opioids, the main drugs used in pain relief, have sedative effect on the brain’s part that
regulates breathing (Brady, McCaudey & Back, 2016). When taken in high doses, the drugs can
depress breathing. In extreme cases, they may lead to respiratory failures and in some instances,
death. This explains why deaths due to overdosing on these drugs have been on the increase
since the 1990s. In 2016 alone, 70,200 Americans died from drug overdose (Wilkerson et al.,
2016). Granted, this figure includes those who died from other drugs such as illicit drugs.
However, the vast majority of these deaths were a result of overdosing on prescription drugs,
particularly opioids. It is estimated that each day 128 Americans die from opioid overdose
(Vadivelu et al., 2018). This figure represents two thirds of all deaths caused by overdose. The
number of Americans dying each year due to overdose of prescription drugs has been doubling
each decade since 1999 when 16,849 people were recorded to have died from the practice
(Wilkerson et al., 2016). The problem is, therefore, an ongoing one. If current trends hold, over
140,000 Americans will be dying yearly by 2030.
Why prescription drug overdose is a uniquely American problem
This history of prescription drugs use in the US explains why the problem is uniquely an
American one. Granted, prescription drugs are used in other countries as well. They also cause
the same problems that they cause in the US such as addiction and overdosing. However, the
extent of usage in other countries is much lower than it is the case in the USA. For instance, the
rate of use of prescription drugs in the US is more than 40% the rate of use of similar drugs in

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other developed countries such as Canada and Germany (Jalal et al., 2018). Other factors unique
to America’s healthcare system have also made the problem more severe in the USA than other
industrialized countries. In the US, alternatives to prescription drugs for pain relief such as
physical therapy are very expensive. For many Americans, their medical insurance often does
not cover these relatively expensive alternatives to pain relieving pills (Platt & Raedle, 2017). If
one does not qualify to be covered by the government, they have to take private insurance which
often only pays for pain relief pills any time one needs to manage their pain (Wilkerson et al.,
2016). A combination of these factors has, therefore, made overdose and addiction to dangerous
painkillers a majorly American problem.
Suggested solutions to the problem of prescription drugs overdose
There are a number of measures that can be put in place to solve the problem of
prescription drug overdose in the US. These measures include both preventive ones and those
that seek to help persons that are already addicted to the drugs and who are, therefore, at risk of
overdosing on them.
One of the most effective of these measures is enhancement of prescription drugs
monitoring programs (PDMPs). PDMPs are databases that healthcare providers can use to track
not just the prescription of prescription drugs that are likely to be misused and which have
serious side effects but also their dispensing (Brady et al., 2016). The goal of this database is to
ensure that healthcare providers avoid inappropriate prescription and dispensing of the highly
addictive pain-relieving drugs (Brady et al., 2016). To make PDMPs effective, there is need to
ensure timely entry of data. Outdated data will be of no help to healthcare providers when
making decisions of whether or not to prescribe a particular opioid.

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Secondly, there is need to have universal use of the database. The problem of misuse of
prescription drugs is not limited to any geographical area, it is nationwide. The use of the
database to guide healthcare professionals when deciding whether to prescribe a given painkiller
to a patient should also be nationwide. Having every healthcare provider enter data into the
database will also improve the quality of the data. With the vast majority of healthcare providers
embracing electronic health records, PDMPs can be embedded into these records thus allowing
them to be easily accessed by healthcare professionals at the point of delivery for effective
decision-making (Brady et al., 2016). Essentially, this database will notify the provider the level
of risk the user has of developing an addiction or taking an overdose. The provider will,
therefore, only prescribe the drugs to persons that have low risk of either developing an addiction
or overdosing on the drug.
Another measure is to improve access to treatment/recovery services for persons that are
addicted to prescription drugs and who are, therefore, likely to overdose on the drugs. Currently,
many users of these drugs who desperately need the services are unable to because of cost
(Brady et al., 2016). Making such services affordable, even free, will significantly increase the
number of people using them and getting rid of their addiction to pain relieving medications.
There is also need to advance better pain management practices. Using pills is not the
only way let alone the only effective tool for managing pain. While the pills help reduce acute
pain, they are not effective in managing long term pain especially for patients with chronic
illnesses (Wilkerson et al., 2016). Methods such as physical therapy are superior in achieving
long-term pain relief (Wilkerson et al., 2016). However, they are relatively more expensive than
pain-relieving pills. Subsiding such low risk pain management measures will help many users to
stop using dangerous pain relieving pills. Additionally, there is need for increased investment in

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search for pain relieving medications that have no serious side effects such as opioids. Such
research will lead to development of drugs that offer the same benefits as current opioids but are
less addictive and, therefore, unlikely to be overdosed on.
Lastly, there is need to identify vulnerable groups and treat them differently from other
groups. The misuse of prescription medications, including overdosing on them is not uniform.
Individuals with chronic illnesses, elders, and adolescents are at a much higher risk of
developing dependence on pain relieving medications than other groups (Wilkerson et al., 2016).
Efforts to solve this problem should, therefore, be focused on these groups of people.
In conclusion, the problem of prescription drug overdose is a dire one that should be
treated as an emergency. A combination of research into less risky pain-relieving medications,
education, information sharing through establishment and maintenance of a nationwide database,
and subsiding current alternative programs for pain relief will help in reducing loss of lives
through overdose of prescription medications. If these measures are taken, the practice may
become the leading killer of Americans in less than a decade.

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References

Brady, K. T., McCauley, J. L., & Back, S. E. (2016). Prescription opioid misuse, abuse, and
treatment in the United States: an update. American Journal of Psychiatry, 173(1), 18-26.
Jalal, H., Buchanich, J. M., Roberts, M. S., Balmert, L. C., Zhang, K., & Burke, D. S. (2018).
Changing dynamics of the drug overdose epidemic in the United States from 1979
through 2016. Science, 361(6408), eaau1184.
Platt, S., & Raedle, J. (2017). The opioid crisis in the USA: a public health
emergency. Lancet, 390(10107), 2016.
Vadivelu, N., Kai, A. M., Kodumudi, V., Sramcik, J., & Kaye, A. D. (2018). The opioid crisis: a
comprehensive overview. Current pain and headache reports, 22(3), 16.
Wilkerson, R. G., Kim, H. K., Windsor, T. A., & Mareiniss, D. P. (2016). The opioid epidemic
in the United States. Emergency Medicine Clinics, 34(2), e1-e23.