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Editorial: Arm doctors with more information about drug abuse, addiction

One of the primary reasons for the resurgence of heroin — in Carroll County, Maryland and across the country — is that addiction can start with a legitimate prescription for pain medication.

People initially prescribed opioid medications like oxycodone for a real medical need can later become addicted. At some point, one of two things — or maybe even both — happen: Doctors realize the patient is seeking a high rather than help and stops prescribing medication, or the person realizes that getting a similar high from heroin costs about a quarter of the price of the prescription drug.

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Some doctors, recognizing that prescription drug abuse was beginning to run rampant, unknowingly turn their patients to heroin by cutting them off from prescription painkillers. It's not fair to blame physicians for this, but it is important that doctors proactively become a bigger part of the solution moving forward.

To do that, doctors need to be closely monitoring what's being prescribed to their patients and to take into account the big-picture problem of addiction.

Because doctors might be the first to suspect a person is "drug-seeking," when they come up with a plan for the patient — this might include no longer prescribing the medications — they should also be connecting the individual with the Carroll County Health Department, which can in turn point that person in the right direction to treat their addiction. Taking the time to do this can be a crucial first step in the long process of recovery. We certainly recognize that many addicts aren't interested in getting help right away — some are still far from admitting they have a problem — but putting the resources in front of them earlier can help.

Some physicians might still need to be educated about how prescribing narcotics can lead to street drug usage. According to local health officials who often see addicts at the end of their rope, not enough doctors are hearing stories of how a valid prescription morphed into heroin use, addiction and overdoses. They believe sharing those stories will go a long way toward changing attitudes about prescription drugs and have already begun outreach efforts in Carroll.

On the federal level, the Obama administration announced in October efforts to, among other things, have more than 540,000 health care providers nationwide complete opioid prescriber training in the next two years. This should help doctors develop better understanding of the problem.

In Maryland, Gov. Larry Hogan's Heroin and Opioid Emergency Task Force recommended that registration and querying of the Prescription Drug Monitoring Program, a statewide electronic database of data on substances dispensed in the state, become a requirement for prescribers. Forcing physicians to access this information before they prescribe painkillers might help show whether the patient legitimately needs the medication to control pain, or if they are "doctor-shopping" for drugs. We encourage the introduction of legislation based on this recommendation and hope it will be passed when the Maryland General Assembly reconvenes next month.

Doctors are in the unenviable position of having to determine what is best for another human being — whether that means deciding that prescribing painkillers is appropriate to alleviate suffering or choosing not to fill a prescription and devising a realistic plan for addiction treatment — and knowing the consequences of either decision. No amount of education or legislation is going to allow them to make the right choice every time. But it is crucial to make sure they have access to all of the pertinent information available about their specific patients' habits — and the plague of prescription drug abuse in general — to help them make that decision.

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