These painkillers work exceedingly well, which is their blessing and curse. Doctors say more Oregonians are becoming dependent on them, both physically and psychologically. The state's fast growth in the rates of fatal overdoses and hospitalizations bolster this assertion.
Oregon can do better, namely by adopting more of the best practices used by other states to fight addictions and prescription-drug trafficking while also protecting patients' ability to manage their pain.
In a recent six-month period, more than 610,000 Oregonians received a prescription for an opiod painkiller, according to a state report. More than 1,700 people showed signs of drug seeking by filling five-plus prescriptions at five-plus pharmacies. Meanwhile, people are dying and landing in the hospital at higher rates for prescription opioid overdoses than for heroin, methamphetamine and other drugs usually considered more dangerous.
Sometimes, the painkiller deaths are accidental, caused by someone over-sedating themselves.
Sometimes, the deaths are suicides, enabled by leftover drugs in a medicine cabinet.
After great delay, Oregon adopted a statewide Prescription Drug Monitoring Program, which requires pharmacies to report prescriptions for certain higher-risk drugs and allows pharmacists and doctors to check that database for red flags. Though this program is gaining steam after roughly 18 months of active use, about 900 of the state's high-prescribing providers haven't signed up to use the system, as The Oregonian's Nick Budnick reported last week.
Time is the biggest barrier, health officials say. So is lack of awareness about the extent of Oregon's painkiller problem.
The state's pain management commission is exploring several changes that may need legislative approval. For example, letting medical staff have access to the drug database would be cost-effective and free doctors to spend more time with patients. Requiring more doctors to study pain management as part of their continuing education would help them learn of changes in the fast-evolving field.
Also, using the database to automatically notify a patient's primary-care doctor when that patient starts shopping around for more painkillers could help prevent budding addictions from developing into major health problems.
Those ideas are worth embracing. Still, a longer-term solution to Oregon's painkiller woes will require a healthier approach to chronic pain itself. That means adding stress reduction, physical therapy and pain-specialty clinics to the mix. It means doctors and insurers -- and most of all, patients -- can no longer assume the best medicine involves stronger painkillers and new bottles for the shelf.