Drug abuse in valley isn’t limited to meth
By Dr. Marc Breen
As an emergency physician at a local hospital, I have seen direct evidence of the prescription drug problems facing the Grand Valley. Every day, it seems, we have patients who present with complaints of nonspecific and chronic pain requesting very large doses of strong narcotic medications such as OxyContin, Vicodin and Dilaudid.
I see many of my patients who include “medical marijuana” among their list of medications, despite having no clinical indication for medicinal use of marijuana. We have marijuana dispensaries that are largely unregulated and indiscriminately prescribe a federally illegal substance without so much as a physical exam. As long as you pay cash, evidence-based medicine doesn’t seem to matter! Unfortunately, in many ways in this litigious and complaint-driven society, the treating physician is held captive to the patient’s demands, and we are often asked to step aside from ethical and evidence-based treatment.
I recently treated a patient who has over 30 emergency visits each year, with complaints of chronic pain, who came in after an overdose of his prescriptions. He had taken various amounts of Methadone, OxyContin and Percocet prescribed by a variety of physicians, and managed to overdose himself. Emergency medical services reported he was somnolent and barely breathing. Of course when he awoke, the first request was for another prescription for pain medication.
I also routinely treat a local “medical marijuana” grower who presents routinely with “marijuana overdoses” and subsequent panic attacks. Yet there’s no regulatory action to prohibit or control this abuse, and he continues to stay in business.
We have very tight regulation from the U.S. Food and Drug Administration regarding every prescription medication produced. Pharmacies are licensed and also tightly regulated. However, in Colorado, the rules and regulations are so loose that almost anyone can get a marijuana card and buy whatever strain of cannabis he or she desires. The downside is that this delegitimizes the use of marijuana for truly medicinal purposes, and opens the door to corruption and unethical practice. We need to remember that there is a reason controlled substances are tightly regulated: Without regulation there is misuse and abuse.
It is my belief that the best approach to avoid drug misuse is education: for the patient and the public. We must all recognize signs of abuse and help our patients, friends and family members through their problems with addiction.
No one is immune to prescription medication abuse. We have heard stories of the prescription medication related deaths of Michael Jackson and Corey Haim, and we routinely see stories in the news highlighting prescription drug abuse among people such as with Rush Limbaugh and Cindy McCain. However, many people do not realize that the only difference between the abuse of OxyContin and heroin is where it’s purchased. Drug abuse is drug abuse. It does not matter where you buy it.
The Grand Valley is plagued by a festering problem that was made worse with the indiscriminant prescription of narcotic medications by two local urgent care physicians who are, thankfully, no longer in business. However, their patients were unfortunately left on high doses of narcotics and nowhere to turn other than the emergency rooms at local hospitals. Regrettably, the emergency department is not able to tackle the huge hurdle of drug dependence, abuse and addiction with a single emergency encounter. Furthemore, we shouldn’t be expected by our patients to prescribe heavy-dose, long-term narcotics for chronic medical problems.
It is easy to think that methamphetamine is the drug most abused in the Grand Valley. Unfortunately, this is being closely followed by prescription drugs such as OxyContin, Percocet, Vicodin — and by marijuana. The next time you stop in to see your physician or the local emergency department, please seriously reconsider your request for narcotic medications or medical marijuana.
Dr. Marc Breen is a board certified emergency physician who works in the emergency room at Community Hospital.