State Senator, Jennifer Flanagan is a Leominster Democrat who leads a legislative task for trying to combat the opiate abuse epidemic. Flanagan had shoulder surgery four years ago and could not believe the amount of pills she was prescribed for pain relief.
"When I had my surgery, I got 40 Percocets. Why 40?" said Flanagan, a Democrat who leads a legislative task force trying to combat opiate abuse.
Studies are showing that more than 80 percent of heroin addicts get their first high from legitimately written prescriptions for pain relief. Flanagan and other politicians have begun to scrutinize doctors for how they are prescribing painkillers so liberally.
One physician described the medical community's unintentional role in the opiate-addiction epidemic as “the perfect storm.” Dr. Daniel Alford said that storm formed in the early 2000s, when more members of the medical community began to recognize pain as the "fifth vital sign" (after body temperature, blood pressure, heart rate and breathing rate) just as drug companies started developing and aggressively marketing new and stronger narcotics.
"We started asking about pain, which is good, but at the same time we had all these new medications that were being developed and marketed, pretty aggressively, to primary-care physicians," said Alford, who serves as director of the Safe and Competent Opioid Prescribing Education program at the Boston University School of Medicine, and director of the Clinical Addiction Research and Education Unit at Boston Medical Center.
The new semi-synthetic narcotics, like Oxycodone, said Alford, were marketed as effective and safe. And, generally, they are, he said, "when taken as prescribed." However when individuals are intent on misusing medications to get high, either through chewing, crushing, snorting or smoking them, more often than not, within a short amount of time that person is in the grips of addiction.
With nearly 90,000 Worcester County residents being written a prescription for opiates in 2013, and nearly 1,300 of those identified as having "activities of concern," Alford said doctors must be vigilant when interacting with patients who are taking a narcotic.
"If you monitor the patient and pay attention to how they're doing, you will pick up the addict," he said. Alford said doctors can use strategies like making the patient bring their pill container to the office during their visit to make sure the pills in the bottle match up with what should have been taken or occasional urine tests.
"We cannot control a patient's behaviors, but it is up to us to be looking for concerning behaviors," said Alford, adding that most doctors throughout the state ask the right kinds of questions but acknowledged there are those who don't follow patients as closely as they might.