The complicated use of prescriptions in modern medicine

Rx 

For most doctors, writing prescriptions is an everyday part of practicing medicine. Yet as we're seeing more often, thanks to researchers, surveys and other important sources, the use of prescription drugs has become complicated in recent years.

According to figures from the National Institutes of Health, over 2 million Americans are addicted to prescription opioids. Additionally, as the NIH added, use of these opioids greatly increases a person's risk of abusing heroin. Understanding the issues surrounding prescriptions is essential for doctors to ensure proper healthcare for every single patient.

"Over 2 million Americans are addicted to prescription opioids."

The over-prescription dilemma

In late 2016, the American College of Physicians surveyed 5,000 random members about the prescriptions they wrote in the year prior. What that survey found was that many doctors are still prescribing drugs when they're totally unnecessary for treatment or patient health. The most frequently prescribed drug type is antibiotics, with over 27 percent of doctors administering them regardless of their effectiveness.

Several months before the ACP's survey, the U.S. Centers for Disease Control and Prevention unveiled a similar study into prescriptions. The CDC found that 1 in 3 antibiotic prescriptions are totally inappropriate, resulting in over 47 million cases each year.

So, why do doctors continue to hand out these prescriptions when many know better? Speaking with UPI, ACP vice president Dr. Amir Qaseem said it's all about patient expectations. Even with simple viral infections, people don't feel as if they're getting proper treatment unless a prescription is involved. This occurs even as most people need little more than bed rest to address certain ailments.

The criminal element

As the problem of prescription opioid addiction continues to impact communities across the country, a novel resolution has made its way into the larger conversation. By making use of solutions like monitoring databases, doctors and police agencies might be able to better control the sale and distribution of prescriptions for illicit purposes. But with those databases comes the potential criminalization of prescription drugs, something that many doctors struggle with.

According to a spring 2013 report from Reuters, 43 states already have these databases in place, and there's been noticeable success in preventing people from "doctor shopping," or obtaining drugs through multiple doctor visits. Even with those promising results, many doctors have come out against the criminalization.

Speaking with the Buffalo News, Dr. Thomas J. Madejski of the Medical Society of the State of New York explained that this process doesn't help by treating doctors like criminals. Additionally, it moves the focus away from the greater issue - that we need to treat addiction more like a disease and not a punishable offense. Plus, many of these databases raise questions about patient confidentiality and just how far the monitoring of healthcare might actually go. It's clear that this is a vastly nuanced issue that requires input from doctors, police agencies and patients alike.

A doctor's larger role

If the policies behind prescription drug use weren't compelling enough, there have been several scientific discoveries that further complicate the picture. In spring 2016, a group of doctors representing the National Academy of Sciences released an intriguing study: Prolonged opioid use in rats can actually increase pain levels. According to the researchers, these drugs "permanently reset amplified pain to basal levels," and that's what caused the rats to remain in a constant state of agitation.

There's a similar effect in humans as well. According to a February 2017 study in the New England Journal of Medicine, patients suffer when doctors over-prescribe. In fact, people are 30 percent more likely to become long-term opioid users when doctors freely hand out prescriptions. If nothing else, that further highlights the responsibility of doctors and the importance of controlling prescriptions to help address this wide-scale issue.