Painkillers as just plain killers.

The U.S. consumes 99 percent of the world-wide hydrocodone supply; prescription drug abuse deaths have quadrupled in the U.S. over the past 10 years and have exceeded traffic related fatalities for at least the past three years.  Figures from the U.S. Centers for Disease Control and Prevention reveal that drug fatalities increased 3 percent in 2010, the most recent year for which complete data are available.  

Preliminary data for 2011 indicate the trend has continued.  The increase was propelled largely by painkillers including hydrocodone and oxycodone, according to just-released analyses by CDC researchers.  The numbers were a disappointment for public health officials, who had expressed hope that educational and enforcement programs would stem the rise in fatal overdoses.

The numbers come amid mounting pressure to reduce the use of prescription painkillers.  The U.S. Food and Drug Administration is considering a proposal to limit daily doses of painkillers and restrict their use to 90 days or less for non-cancer patients.  The proposal also would make such drugs available to non-cancer patients only if they suffer from severe pain.

Among the most promising tools to combat the problem are computerized drug monitoring programs that track prescriptions for painkillers and other commonly abused narcotics from doctor to pharmacy to patient.  Texas launched their program – Prescription Access in Texas (PAT) – in June 2012.  The White House Office of National Drug Control Policy leader, R. Gil Kerlokowske, calls for aggressive monitoring of databases by state medical boards.  Some believe such programs should be used to monitor doctors' prescribing as well as patients' use. 

But the system needs to be used proactively in order to see change.  Lynn Webster, president-elect of the American Academy of Pain Medicine, said the new figures underscored the need for further action, such as educating physicians to recognize patients who are at risk for abusing painkillers.

Florida was the media’s first “pill mill capital.”  The state was a place where loose or nonexistent regulations let illicit pain clinics and unscrupulous doctors overprescribe oxycodone and other powerful medications to drug dealers and addicts.  Thanks to an effective state task force, the U.S. Drug Enforcement Administration oversight, and the online Prescription Drug Monitoring Program, the Florida doctors listed as top buyers of oxycodone have plummeted from 90 in 2010 to zero today.

But amid pharmacy retailers enhancing schedule II dispensing policy, state legislatures voting in new, more aggressive regulation, and DEA involvement, what else can be done to control painkiller abuse?

A group of Brigham Young University students redesigned the prescription bottle and have developed a high-tech regulator of medication.  Their invention, called Med Vault, lets a pharmacist give instructions to the bottle, which then dispenses painkillers accordingly to the patient.  The students claim the complex gadget is tamper-resistant and break-resistant.  The Med Vault requires users to put in an access code to get a pill, making it harder for the drugs to get into the wrong hands.

The project began as part of BYU’s Engineering Capstone program.  At this time, a patent has been filed and the team’s sponsor wants to take the bottle into production.  (Pictures on the right bar.)