Some U.S. States Have More Painkiller Prescriptions Than People

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vertIllustrated By Naomi Abel.
What public-health crisis claimed the lives of 16,500 Americans in 2010 and now kills 46 per day? Opiate overdose. The U.S. is recognized as the most overly-prescribed nation in the world, and now we know just how scary-high that number is: According to a Centers for Disease Control and Prevention (CDC) report, U.S. healthcare providers wrote 259 million narcotics prescriptions in 2012 — enough for every single American to have his or her own pill supply.

The most opiate-addicted states are Alabama, Tennessee, and West Virginia. Alabama and Tennessee lead the pack with a whopping 143 painkiller prescriptions for every 100 people; at 138 prescriptions per 100 people, West Virginia’s not far behind. At a loss for how to treat chronic pain (and/or badly informed about the dangers of prescription medication), a doctor will often prescribe multiple opiates to a single patient. Most painkillers are prescribed by primary care or internal medicine doctors, not specialists, and some of these docs are more prescription-happy than others: 20% of prescribers write a staggering 80% of prescriptions. And, prescription patterns vary wildly; healthcare providers in Alabama prescribe three times the amount of painkillers that doctors in the lowest-prescribing state, Hawaii, do. In fact, eight of America's 10 highest-prescribing states for narcotics are in the south.

The Obama administration and members of Congress have proposed legislation that requires doctors to take a course on narcotics before they're allowed to prescribe them. Seems like a no-brainer, but as of now, any licensed doctor can prescribe dangerous (and potentially deadly) painkillers, regardless of his or her training in drug abuse prevention. Opponents of mandatory training claim that such a requirement would interfere with doctors’ ability to provide their patients with the best care.

Legislation or no, it’s clear that something must be done. Since 1990, rates of death by overdose on any drug have more than tripled and are now at an all-time high. A study of the 36,000 drug overdose deaths that occurred in 2008 showed that over half were caused by prescription drugs. When a licensed physician writes you a prescription, it’s easy to underestimate the drug's danger. If your doctor recommends it, it must be okay, right? Wrong. It's time for doctors and patients alike to take a closer look at our ingrained (and misled) attitudes toward opiates.