Alabama Board of Medical Examiners Chair Dr. Jerry Harrison said Alabama led the country in the number of prescription pain killers from 1987 until 2001, and stayed in the top five from 2002 through 2006.
“There’s no scientific evidence that Alabamians should hurt worse than other people,” Harrison said. “We may high a slight increased legitimate need for pain medication, but I don’t think we have a legitimate need for the amount of narcotics being prescribed.”
Harrison said the top painkiller prescriptions were once Loritab, Vicodin and Lorcet. However, in January of this year, according to Harrison, those brands were replaced by Norco. Harrison said no matter what brand, all of these painkiller prescriptions have hydrocodone as an active ingredient and “it’s hydrocodone that Alabama has been number one in.”
“It’s a reflection of the society, the doctors and the patients. Many patients go to doctors and tell them they’re hurting, and they may be hurting. But life is not pain free and if we try to make life pain free, we sometimes can get to the point where the medications themselves have rebound effects that cause a person to perceive more pain,” Harrison explained.
Harrison added that doctors are empathetic, and when a patient asks for more pain killers some doctors are more comfortable with prescribing additional prescriptions or increasing the dose rather than reasoning with the patient. This practice could also draw in more patients to a healthcare provider.
“We have competing factors. We have patients who don’t want to hurt more and they feel decreasing the amount of pain medicine will make them hurt more. Then we have physicians who use prescribing as a way to get more patients in their office. When those two factors intersect, we have a problem,” Harrison said.
The CDC’s Health Communication Specialist Courtney Lenard said some of the increased demand for prescription painkillers is from people who use them non-medically, using drugs without prescription or just for the high they cause, selling them or getting them from multiple prescribers at the same time.
The Alabama Board of Medical Examiners started a series of lectures in 2009 in an attempt to tackle the high number of prescribed painkillers by speaking about the issues. A few years prior to that Harrison said the board initiated a prescription drug program.
“We feel we are beginning to make an impact but with this new data is certainly says the Board of Medical Examiners definitely has a challenge in front of us,” Harrison said.
Lenard said that because of the risk of painkiller drugs, it’s critical to consider whether benefits outweigh risks when prescribing them. “High rates of use might expose populations to greater risks of overdose and falls. Therefore it is particularly important to reduce inappropriate prescribing where prescribing rates are highest,” Lenard said.
Although the number of painkiller prescriptions in Alabama is high, Harrison said the number of prescription drug overdoses has decreased. However, with that came an increase in the use and abuse of heroin in the state.