Monthly Archives: March 2014

Alcohol, driving and the truth

As a criminal defense attorney, I handle a fair amount of DUI (driving under the influence) cases (known as OVI -Operating vehicle under the influence of alcohol or drugs-here in Ohio).  These defendants simply represent the people who got caught.  The FBI statistics report that 1.2 million people were arrested for DUI in 2011.  I can’t even fathom a guess as to how many people drive under the influence per every driver that gets arrested.  Another 100, or 1,000?

Either way, the latest data suggests that there is an underreporting of the role alcohol plays in traffic deaths.  Part of the problem is the delay in getting the coroners results in time before an official police report is filed.  Some states don’t even list alcohol on death certificates.

It is interesting how readily our society accepts casual alcohol use.  We see commercials on television that suggest alcohol use is fun and without negative effects.  As parents, we drink in front of our kids, sometimes to excess, and simply tell them not to do what we have done.  The whole relationship with drinking changed after prohibition.  We went from thinking it was an evil substance to thinking it was the nectar of the Gods.

Admittedly, the majority of people who drink do not have negative consequences.  But for those that do, it can be devastating.  I implore people to be more conscious of their drinking and definitely think before they get behind the wheel of a vehicle after drinking.

Bezodiazepines Rx’s with opioids increasing year after year

While we were looking the other way (Rx opioids), the benzodiazepine class (Xanax, Valium, Klonopin, etc) have been creeping up in the prescription tally. It has been known for years that “benzos” are addictive. They are also considered by addicts as a drug that helps increase the duration and intensity of opioids. They are also used to reduce the withdrawal effects of various drugs of abuse. They are also one of the hardest drugs to withdraw from.

Benzos got their start in the public psyche as “mother’s little helper.” They increase GABA, an inhibitory neurotransmitter, that in turn relaxes the patient and reduces anxiety. Hence the class term of “anxiolytics.” These drugs are extremely dangerous for many reasons. The opioid potentiation effect probably the most notable during the current opioid/heroin epidemic.

Doctors need to be re-schooled (or just schooled) about addiction. Many have no inkling what causes addiction, the normal course of addiction and how their prescribing habits affect addiction and society in general. Mandatory prescription monitoring needs to be in place in every state. When a doctor writes for an addictive drug, it needs to be logged in the database and all Rx’s that get presented at a pharmacy need to be logged in the same database by the pharmacist. Right now, most state monitoring databases are voluntary (hello, Ohio!).

If we can track a pair of socks from Amazon.com all over the country, we can track dangerous prescription drugs. When I was a pharmacist in Illinois, we had triplicate prescription blanks for all CII narcotics. That means the MD writes the Rx and sends one copy to the DEA, and the other 2 to the pharmacy. The pharmacist fills the Rx and sends one copy to the DEA and retains the original. We need better ideas, not ones based on greed, to start saving our on members of society. We can’t trust the medical profession to do it for us.

Non-doctors writing millions of painkiller Rxs.

When we think about prescription pain killers, or opioids (aka opiates), we think about doctors who write for them.  Well, they are only part of the source of the supply of these drugs.  With the deluge of patients on the medical system, due in part to an aging population, and increases in treatment modalities, state medical boards have allowed an entire army of other prescribing sources.  Doctors just don’t have enough hours in a day to meet the demand, so physician assistants (PA’s), nurse practitioners (NP’s), and others in some states, have taken up the slack.

Unfortunately, when you get more players in the prescribing arena, you get less oversight by the boards that created them.  Especially in this day and age of post recession when medical board budgets are strained.  There are fewer investigators to keep track of all of these new writers of dangerous drugs.

The federal government is clamoring for more oversight, but the states have yet to respond.  Sure, most states have implemented prescription monitoring programs, but most are not require mandatory reporting.  The pain killer to heroin to overdose death spiral has cost too many lives already.  it is time we put human lives before greed, with required monitoring and increased oversight of prescribers.

Drug and alcohol treatment funding

The editorial board of the largest news paper in Ohio, Cleveland’s Plain Dealer, has made a direct demand to the Governor of Ohio to make drug and alcohol treatment funding a priority.  As a drug counselor, social worker, criminal defense attorney and recovering addict myself, I can’t agree more strenuously.  Right now, treatment for the disease of addiction is rarely available on demand,  Typically, wait times for entry into treatment run from 2 weeks to 2 months.

Though we hear more about heart disease and cancer, because we understand those to be diseases, many addicted clients suffer from the most costly disease in the world.  Addiction results in the following forms of direct and indirect financial costs: under productivity at work due to “hangovers”, not showing up for work, car accidents, assaults/domestic violence, divorce, bankruptcy, foreclosure, arrests, diseases (cirrhosis of the liver just to name one) treatment, and the list goes on.  Addiction costs roughly $524 billion per year in America.  More than heart disease and diabetes combined.

We need to understand that our loved ones do not want to live this way.  Addiction is not a choice.  No one would “choose” to act in ways that destroy their lives and the lives of others.  Sure, there was the initial choice to pick up a drink or a drug, but after that, many of us have no control and simply cannot stop without medical assistance.  I encourage everyone touched by this disease to speak out and ask your legislators to make more money available to treat these very sick individuals.