Earlier this month the Massachusetts Senate voted unanimously for a new bill that would add greater controls to prescription drugs in the Commonwealth. People are finally waking up to the fact that it is the prescription opiates, provided by well-meaning medical professionals as pain controls, that have become the “gateway” drugs to heroin.
The bill now moves to the House, where co-author Rep. Elizabeth Malia, D-Jamaica Plain, will present it. A 2010 law established a monitoring system for physicians in the Commonwealth but because it was voluntary, only 1700 of 40,000 doctors signed up. The new bill proposed by Sen John Keenan of Quincy requires doctors to register with the state before being permitted to prescribe opiate painkillers. This will prevent addicts from obtaining multiple prescriptions or obtaining amounts in excess of their actual medical need. This not only prevents abuse by the addict receiving the prescription, but also prevents extra amounts from being sold for street use.
What the bill does not address and is a missing piece to drug abuse prevention is the need for professional education on addictions, drugs of abuse and street drugs. Although most professionals such as doctors, psychologists, social workers and counselors spend many years in advanced training and education programs, many of these programs do not provide curricula addressing these issues. This results in missed diagnoses, undertreating of identified disorders and inappropriate prescriptions that lead to and support addictions.
For an ongoing physical disorder, or post-surgery for a medical procedure, painkillers can be a blessing. However, if you have an addictive disorder, a concerted effort must be made to appropriately manage a painkiller prescription so that it does not exacerbate the addictive disorder. The following are some suggestions that have been helpful to addicts in the local area who have experienced these challenges:
1. Make sure you are working with doctors and counselors and who fully understand addictions and the various drugs that are risky to use with an addict.
2. If you are undergoing a medical procedure that may call for painkillers after the operation, work out a plan with your providers before the procedure.
3. Establish a close relationship with someone you can trust (this may be a family member, a sponsor in a self-help program or a close friend). Make them part of your plan.
4. Only accept prescriptions for small supplies (e.g. 3 days worth, 7 days worth) and make sure all of your providers and your trusted friend know how much you have at any given time.
5. If you have an on-going pain problem, develop and implement a similar plan. Consider alternative methods to manage pain (e.g. acupuncture, meditation) and consider tapering off the pain medication at some point in the future.
Maintaining sobriety in the face of these powerful drugs is possible, but it takes a lot of hard work.