Federal organizations have started to work on solutions as well. Last July the Food and Drug Administration began requiring drug companies to start educating doctors about the special risks of such prescription drugs. The CDC has called on states to consider monitoring Medicaid or workers' compensation claims “for signs of inappropriate use of controlled prescription drugs.” To help reduce doctor shopping, the CDC says, these state programs might in some cases consider restricting reimbursement for controlled drugs to scripts that come through only one designated prescriber per patient and one designated pharmacy.

Mycyk has started telling the ER physicians he trains that they might save more lives by asking more specific questions than the ones they learned to ask in medical school. “Don't ask, ‘Do you abuse illegal drugs?’” he says. “Most of the drugs people are using today are not illegal. A lot of them are overdosing on drugs that were prescribed by their doctor.”

Instead, Mycyk says, asking questions such as “Have you ever gotten high on cough syrup?” or “Have you ever taken a friend's or relative's pills?” will put you on the right track to more helpful responses. “Most [patients] will do all they can to help you,” he says. “In most cases, landing in the ER was an accident. They don't want to die.”

SCIENTIFIC AMERICAN ONLINE
Comment on this article at ScientificAmerican.com/oct2012

This article was originally published with the title Drug Detectives.

4 Comments

1. 1. i8amouse 03:05 PM 10/13/12

   People don't want to die? Oh, I guess you can read peoples minds? Or maybe you just don't want them to commit a sin because they won't go to heaven? Maybe if they had to go to church they would know better. Oh they don't go to church? Well maybe we should make a law that they have to go to church too!

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2. 2. Diesel67 05:55 PM 10/15/12

   Don't buy from the Chinese Commies. Their quality control stinks. America still has plenty of chemical companies monitored by the FDA and others.

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3. 3. gcisneros 02:34 PM 10/28/12

   Re: "Bored teens" and "patients who double down", mentioned in the third paragraph, might be worthy candidates for the Darwin prize.

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4. 4. ForMaddenedProphets 12:53 AM 12/26/12

   When you couple a brilliant yet abuse-prone drug delivery mechanism such as the sustained/extended release 'matrix' systems with the narcotic dose these formulations, by design require, you are bound to have problems.
   
   Before that form of Oxycodone was released in Australia, the only other oxy preparation available was 5mg Endone. No use to a user as it was unable to be crushed, dissolved and injected. As were all the other potent, oral narcotics. Maize starch and/or cellulose as excipients turned the crushed tablet into a gluggy, uninjectable mess. The desperate drug fiend would sometimes even attempt to give that a go.
   
   This all changed in the late 90's with the introduction of the various ...Contin formulations being incorrectly prescribed for less severe pain...the ubiquitous 'Bad back'.
   The legalities in Australia state that a doctor may prescribe a drug of addiction for a period of 8 weeks before a permit from the Health Department is required.
   
   One can visit many doctors in 8 weeks with a cock-and-bull story and if you are unemployed, 80-90% of the cost of the doctors consultations and the drugs themselves are subsidised by the Government.
   
   I've been down this path and I know the only thing that will stop it is the introduction of e-pharmacy or electronic prescribing ONLY IF the records are updated in real-time.
   
   The Government have been trying to implement such a scheme for the last 5-10 years, with not much success.
   Between the substantial costs involved and the protestations of the civil rights/privacy loby groups, it will be a few years yet.

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