Prescription painkiller abuse and the related resurgence in heroin addiction have reached the point that the recently appointed Presidential Commission on Combating Drug Addiction and the Opioid Crisis on July 31, 2017, felt compelled to call for an immediate declaration of a national emergency. Taking the action would free up federal personnel and money to address a problem that, according to CDC estimates, claims 142 lives across America each day.
On the same day, CBS News highlighted research showing that the percentage of U.S. drivers found with measurable concentrations of opioids in their systems after they died in crashes rose sevenfold from 1995 to 2015. A report posted to the American Journal of Public Health website on July 20, 2017, states that “toxicological tests for drivers fatally injured within 1 hour of a crash [revealed that] prevalence increased from 1.0% in 1995 to 7.2% in 2015.” Women who died in wrecks were significantly more likely than men to have used opioids. Among the 36,729 fatality records studied, 30.0 percent of people also had blood alcohol concentrations greater than 0.01 g/dL and 66.9 percent tested positive for other drugs in addition to an opioid.
In a press release issued along with the journal article, principal investigator Guohua Li, MD, DrPH, who is a professor of epidemiology at the Mailman School of Public Health, noted, “The opioid epidemic has been defined primarily by the counts of overdose fatalities. Our study suggests that increases in opioid consumption may carry adverse health consequences far beyond overdose morbidity and mortality.”
That press release also offers this detail: “Annual prescriptions of opioids such as oxycodone, hydrocodone, and methadone, quadrupled from 76 million in 1991 to nearly 300 million in 2014. With latest estimates at 3,900 people initiating nonmedical prescription opioid use daily, opioid abuse and overdose has become a national public health crisis.”
A partial list of opioids and the brand name medications that contain those heroin-like generic drugs prepared for WebMD includes
- Codeine (only available in generic form)
- Fentanyl (Actiq, Duragesic, Fentora)
- Hydrocodone (Hysingla ER, Zohydro ER)
- Hydrocodone/acetaminophen (Lorcet, Lortab, Norco, Vicodin)
- Hydromorphone (Dilaudid, Exalgo)
- Heperidine (Demerol)
- Methadone (Dolophine, Methadose)
- Morphine (Astramorph, Avinza, Kadian, MS Contin, Ora-Morph SR)
- Oxycodone (OxyContin, Oxecta, Roxicodone)
- Oxycodone and acetaminophen (Percocet, Endocet, Roxicet)
- Oxycodone and naloxone (Targiniq ER)
CBS noted that each of these products has the potential for causing drowsiness, impairing thinking and slowing reaction time. Jim Hedlund, a spokesman for the Governors Highway Safety Association told the network, “It’s up to doctors and pharmacists to tell their patients that these drugs can impair driving and not to take them when they drive.”
Looking into how specific opioid products and doses affect driving performance is particularly important, according to Li. Since the medications have legitimate therapeutic uses, they will continue being used. Figuring out how to keep drivers on pain management regimens that offer relief without endangering them and others on the road could save lives.
Virginia has implemented strict new rules for prescribing and dispensing opioids. Those guidelines primarily focus on preventing misuse and the reselling of prescription medications. An update to emphasize warnings about the dangers of driving and operating heavy equipment may be in order.
My Virginia wrongful death attorney colleagues and I have witnessed the growth of drugged driving fatalities firsthand. Anything public officials, health care providers and researchers can do to reduce such tragedies will be welcome.