AP: Pain Medicine Use Has Nearly Doubled

Dr. John Charles, Director of Medical Affairs at the Grand Strand Regional Medical Center in Myrtle Beach, S.C. speaks during an interview with The Associated Press in Myrtle Beach, S.C., Nov. 20, 2006. A few years ago, Charles said, he took a drastic step to reduce his potential legal risks: He stopped prescribing painkillers. The decision gave him peace of mind, but he doesn't expect there to be less need for painkillers or physicians who prescribe them. "People with cancer are surviving longer, elderly people are living longer," Charles said. "So, physicians are walking a fairly fine line. We're walking a narrow path. And I think we'll continue to see it for a while." (AP Photo/Willis Glassgow) (Willis Glassgow - AP)

The DEA figures analyzed by the AP include nationwide sales and distribution of drugs by hospitals, retail pharmacies, doctors and teaching institutions. Federal investigators study the same data trying to identify illegal prescription patterns.

An AP investigation found these reasons for the increase:

_The population is getting older. As age increases, so does the need for pain medications. In 2000, there were 35 million people older than 65. By 2020, the Census Bureau estimates the number of elderly in the U.S. will reach 54 million.

_Drugmakers have embarked on unprecedented marketing campaigns. Spending on drug marketing has zoomed from $11 billion in 1997 to nearly $30 billion in 2005, congressional investigators found. Profit margins among the leading companies routinely have been three and four times higher than in other Fortune 500 industries.

_A major change in pain management philosophy is now in its third decade. Doctors who once advised patients that pain is part of the healing process began reversing course in the early 1980s; most now see pain management as an important ingredient in overcoming illness.

Retired Staff Sgt. James Fernandez, 54, of Fredericksburg, Va., survived two helicopter crashes and Gulf War Syndrome over 20 years in the Marine Corps. He remains disabled from his service-related injuries and takes the equivalent of nine painkillers containing oxycodone every day.

"It's made a difference," he said. "I still have bad days, but it's under control."

Such stories should hearten longtime advocates of wider painkiller use, such as Russell Portenoy, head of New York's Beth Israel pain management department. But they have not.

"I'm concerned and many people are concerned, that the pendulum is swinging too far back," he said.

Consider:

_More people are abusing prescription painkillers because the medications are more available. The vast majority of people with prescriptions use the drugs safely. But the number of emergency room visits from painkiller abuse has increased more than 160 percent since 1995, according to the government.

_Spooked by high-profile arrests and prosecutions by state and federal authorities, many pain-management specialists now say they offer guidance and support to patients but will not write prescriptions, even for the sickest people. The increase in painkiller retail sales continues to rise, but only barely. There was a 150 percent increase in volume in 2001. Four years later, the year-to-year increase was barely 2 percent.