Editorial: Living up to their name, painkillers are placing too many victims in the morgue

November 25, 2012 

Dr. Naga R. Thota says prescribing painkillers is like "playing with fire." Since 2005, at least 15 of his patients have died of overdoses.

LIZ O. BAYLEN — Los Angeles Times file, 2012

Chronic and serious pain is debilitating and should not be minimized.

However, there is troubling evidence that physicians and regulators have failed to properly monitor over-prescribing of powerful and addictive pain medication.

Narcotic painkillers have become among the most widely prescribed drugs in the nation, and people are dying prematurely as a result.

Authorities who should know the depth of the problem were unaware of it – until, that is, the Los Angeles Times offered its findings earlier this month in an article that also appeared in The Bee.

As the article noted, prescription drug overdoses claim more lives than heroin and cocaine combined. The Centers for Disease Control and Prevention has called prescription drug abuse an epidemic.

Reporters Scott Glover, Lisa Girion and Hailey Branson-Potts did the hard work of picking through coroners' records from 2006-11 in Los Angeles, Orange, Ventura and San Diego counties. They identified 1,766 deaths for which the deceased had prescriptions for the drugs that were the sole or contributing causes of death.

They found that 71 physicians wrote prescriptions for drugs that caused or contributed to 298 deaths. Four doctors had 10 or more patients who died of overdoses.

One, Dr. Van H. Vu, a Huntington Beach pain specialist, had the highest number of deaths, 16. Incredibly, Vu was unaware of the damage caused by the narcotic painkillers he had prescribed, until the reporters told him.

A reason for the blind spot is that coroners are not obligated to track down the physicians who prescribe the death-causing pills. Nor are they required to inform the California Medical Board.

Americans are big consumers of pain meds. Fifteen years ago, heavy painkillers were given at the end of life to relieve the pain of cancer and other painful conditions. Now, there are 300 million prescriptions a year of the heroin-like drugs. The increase coincided with heavy advertising and lobbying by pharmaceutical companies.

In Sacramento this year, the Legislature in a bipartisan vote approved Assembly Bill 369, a measure carried by Assemblyman Jared Huffman, D-San Rafael, who was elected to Congress this fall.

The bill sought to streamline the ability of physicians to prescribe painkillers without going through so-called step therapy, in which patients must try lesser methods of pain relief such as over-the-counter remedies.

In legislative hearings, individuals who suffered from severe pain gave emotional testimony. Undoubtedly, they received relief from the pills they ingested and used them responsibly. Nor do we doubt that insurance companies can set up unreasonable barriers.

But drug companies also worked to shape Huffman's legislation. Lobbyists' public disclosures show pharmaceutical giant Pfizer and Purdue Pharma, manufacturer of OxyContin, a chemical cousin of heroin, worked on the bill. The measure would be law but for a veto by Gov. Jerry Brown.

As the Los Angeles Times noted, narcotic pain relievers cause or contribute to nearly three out of four prescription drug overdoses. For every death, 32 overdose victims are treated in emergency rooms.

Clearly, safeguards aren't working. At a minimum, lawmakers need to require county coroners to inform physicians and the medical board of prescription painkiller-related deaths, and authorities need to systematically mine the data to identify physicians who are overprescribing and whose patients are dying.

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