Karl B. Hille, The Examiner
2007-08-29 07:00:00.0
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BALTIMORE -

Linda Simoni-Wastila, BSPharm, Ph.D., is an associate research professor at the University of Maryland School of Pharmacy and director of the Long-Term Care Initiative at the Lamy Center.

She spoke to The Examiner recently about the dangers of addiction to painkillers — prescriptions of opium derivatives including codeine, morphine, oxycodone and hydrocodone have doubled in the last 10 years.

How do you protect patients from dependence or addiction?

There’s a lot of controversy over how many people who use prescription painkillers for a legitimate need actually become dependent to the point of addiction. We don’t have any really good measures of what is dependence and what is problematic use. If you’re using a medicine because you want to get a certain feeling rather than to alleviate the pain, it’s a problem. There’s nothing we do to watch patients for signs of addiction.

Can doctors in private or family practice keep up with all the latest laws and research on these drugs?

Specialists in pain medication can. Your family practitioners just can’t do it. They don’t have the time. I think what makes a difference is what happens at a state and regional level in terms of electronic prescription-monitoring programs. The Maryland attorney general last year was trying to push something like that through.

Do we run the risk of over-regulating legitimate drugs to the point where patients can’t get treatment for pain?

When you do put that sort of program in place, people who legitimately need those drugs don’t get them. We call that the chill effect. It’s a huge issue. I think the big thing is what is the balance between effective clinical care and abuse.