Even though there have been many warnings about the potential for abuse, it is still ridiculously easy to get a prescription of certain dangerous medications. According to a December 2014 article co-published by the USA Today, NPR’s Shots blog, and ProPublica, Medicare covered almost 27 million prescriptions for dangerous narcotic pain medication and stimulants in 2012, the most recent year for which data is available. That is an increase of 9% from 2011. To put that number in perspective, that is nearly double the rate of increase for Medicare medications overall. The spike is in a category of drugs that are classified as Schedule 2 controlled substances by the Drug Enforcement Agency. Examples of these would be morphine, fentanyl, oxycodone, and Ritalin. Because these drugs have a high potential for abuse, the Drug Enforcement Agency places limits upon their prescribed. Schedule 2 drugs must have a written prescription and they cannot be refilled. Many doctors get around this via a loophole – they give their patients a 90-day supply by writing multiple prescriptions during a single visit.
Problem Prescribers
For the most part, an individual who abuses prescription drugs is nothing like the stereotypical image that one typically thinks of as a “drug addict”. Often, the people who are abusing these drugs don’t feel as if they’re doing anything wrong. After all, they usually have valid prescriptions. In fact, according to the Centers for Disease Control, only about 15% of the prescription medication misused by “chronic abusers” actually comes from an illegal source. Nationwide, “problem prescribing” is rampant. Look at some of these statistics:
- Of Medicare’s top 20 prescribers of Schedule 2 drugs in 2012, 60% either faced criminal charges directly related to the practices or disciplinary sanctions by their state medical boards.
- The top provider, a doctor in Alabama, gave out over 14,000 Schedule 2 prescriptions in 2012. In 2013, his right to dispense controlled substances was suspended by the state medical board, and in July, he gave up his medical license. An audit of the doctor’s records showed that 80% of his patients had at least one prescription for a Schedule 2 medication. By comparison, in the state of Alabama, all other doctors within his specialty prescribed Schedule 2 drugs at a rate of 38%.
- Across the country, 269 physicians each wrote more than 3000 Schedule 2 prescriptions. Of those 269, approximately 20% – 1 in 5 – were sanctioned or investigated.
- 4% of the country’s prescribers wrote 50 % of all prescriptions.
Possible Solutions
Obviously, over-prescribing is a real and present danger here in the United States. So what can individual patients do to ensure that they are not needlessly prescribed dangerous and addictive prescription medications and opioids? It all begins with the conversation you have with the attending physician. Before prescribing you any medication, your doctor should discuss with you alternatives – nutrition, exercise, diet, lifestyle changes, natural supplements, and stress/pain management techniques.