The death of actor Philip Seymour Hoffman focused attention on the problem of heroin, but heroin isn't what's driving the overdose epidemic, says Governing magazine. Prescription painkillers are. “We [in the medical profession] are the drug dealers,” says Dr. Terry Cline, Oklahoma's health commissioner and the former head of the federal Substance Abuse and Mental Health Services Administration. “We are keeping these drugs accessible.” Since 1999, the number of prescription painkillers sold has quadrupled. Over that same period, overdose deaths have risen more than threefold. In 2009, overdoses involving opioid painkillers such as OxyContin, Percocet and Vicodin killed some 15,500 people, more than twice as much as heroin and cocaine combined.
Efforts to crack down on prescription painkillers pose difficult problems. For one thing, the problem of chronic pain is real. About 100 million Americans suffer from chronic pain, with some 10 million disabled by it. There is also the problem of unintended consequences. A decade of abuse has created a large population of opioid-dependent people. In 2010, some 12 million people admitted to using opioids such as OxyContin “non-medically.” “We caused this problem, and it's incredibly important that we as a medical system try to address it without harming more people than we have already harmed,” says Dr. Phillip Coffin, director of Substance Use Research at the San Francisco Department of Public Health. “There are a thousand ways to do this wrong, and just a couple of ways we can do it without harming an undue number of people.”