Electronic prescriptions are creating a new Heroin Crisis, Doctor says

Starting this week, New York has mandated electronic prescriptions as a way to streamline the prescription process, and stop fraud and abuse. This reform was put into action in order to improve patient safety, reduce the number of fraudulent or stolen prescriptions, and combat prescription drug abuse across New York.

How did prescription pads allow for painkiller fraud and abuse? Paper prescriptions had gotten to a point that they were traded even more easily than actual drugs.

Prescriptions were stolen or forged on paper prescriptions, not to mention that errors were frequent on these paper prescriptions. Handwriting could easily be misinterpreted, and it was easy to change things slightly without anyone noticing an issue.

Electronic prescriptions are a key component of New York's I-STOP law adopted in 2012. The law aimed to curb prescription drug abuse by creating a system so doctors can check whether a patient recently filled a prescription for a pain medicine.

The program has cut down on the number of controlled-substance prescriptions, from about 24.3 million in 2013 to 23.9 million last year.

This measure will cut down on prescription painkiller fraud by making it more difficult to create fraudulent prescriptions and getting rid of paper pads.

The issue is larger than this however, as the demand still exists with these highly addictive substances. What we have seen is a surge of heroin abuse as prescriptions have decreased, which is a testament to the demand of these painkillers.

 

The new e-prescribe measure contributes to the heroin crisis.

Heroin deaths and addiction to prescription painkillers have been on the rise. In fact, overdose deaths involving heroin increased by 45% between 2006 and 2010.

The National Institute on Drug Abuse says that every day, an average of 2,000 teens use prescription drugs without a doctor's guidance for the first time. Similarly, nearly 15% of high school seniors have reported non-medical use of prescription medications.

Prescription drugs are seen as a gateway to heroin; unfortunately heroin is a much cheaper way to get the same high. The two are linked in the following way:

Pain killers

- Patients who don't need medications are getting prescribed medications that they don't really need

- Easy access to the pain killer if taken from the parents

- The Partnership at DrugFree.org in 2012 found that 42% who misused a drug got that pill from their parent's medicine cabinet

- A study found 49% said they got those pills from a friend

- 16% have not discussed the abuse of prescription pain killers, but 80% of parents have spoken to their teenagers of the dangers of cocaine, marijuana, and alcohol

Heroin

- Cheaper way to get high

- When pills become too expensive and provide an insufficient high, they turn to heroin

- Lack of education and misinformation is a problem

There’s a reason why heroin is more available and cheaper than ever.

The crackdown on prescription medication abuse has created a surge in heroin abuse. Because there is less access to prescription drugs, abusers turn to heroin.

Sadly, when patients can no longer get the prescription drugs, they turn to street drugs like heroin. This is where we find that the demand for heroin has increased dramatically. This means street value for heroin has increased to fill demand, and as policy controls continue to tighten, street value rises in response.

Interestingly, these events have coincided with a decline in demand of Mexican marijuana, because of increased availability of medical marijuana. Cartel farmers south of the border have replaced cannabis plants with opium poppies, in alliance with market demand.

Competition between drug groups has increased supply, driving access to cheaper heroin.

Unfortunately, the heroin crisis is getting worse.

As prescription policy tightens, the heroin crisis will only get worse because demand will increase. As long as the supply exists — and now there is more supply than ever — and competition is driving the cost down, the heroin issue will exist.

The relative cost of heroin is significantly lower than getting the same effect from prescription pills.

Furthermore, treatment for heroin addiction is more expensive and less accessible than heroin itself. Private rehabilitation typically costs tens of thousands of dollars for only several months of treatment, while public treatment programs have waiting lists that are months or years long.

Ultimately, it will be necessary to set up a system to better address drug abusers trying to get clean, and allow for options to detox.

Dr. David Samadi is a board-certified urologic oncologist trained in open and traditional and laparoscopic surgery, and an expert in robotic prostate surgery. He is chairman of urology, chief of robotic surgery at Lenox Hill Hospital and professor of urology at Hofstra North Shore-LIJ School of Medicine. He is a medical correspondent for the Fox News Channel's Medical A-Team and the chief medical correspondent for am970 in New York City, where he is heard Sundays at 10 a.m. Learn more at roboticoncology.com and SamadiMD.com. Follow Dr. Samadi on Twitter and Facebook.