醫實注行
專家解讀“麻醉痛症專科”（亦稱“疼痛科”）及＂麻醉科＂專業知識及應用問題 - pain management
40 U.S. Deaths a Day From Prescription Painkillers
Nov. 1, 2011 -- Every day, 40 Americans die from prescription painkiller abuse, the CDC says.
Overdoses of opioid prescription drugs now kill more people in the U.S. than do overdoses from heroin and cocaine combined. Twelve million Americans say they abused prescription drugs in the last year.
It's not just a statistical blip. Prescription drug abuse -- taking painkillers not for pain, but to get high -- has tripled since 1999. Rogue doctors are a big part of the problem, according to CDC Director Thomas Frieden, MD. Indeed, a California study found that 3% of doctors wrote 62% of painkiller prescriptions.(注譯：在加州，3%的醫師處方了62%的處方鎮痛藥，＂話外音＂：記住，有3%的醫師是醫師中的敗類，每各行業都有敗類，醫師中也不例外。）.
"This stems from a few irresponsible doctors," Frieden said at a news teleconference. "The problem is more from them than from drug pushers on street corners."
As a result, one in 20 U.S. adults admits to having abused prescription narcotics. The drugs most abused, according to the CDC, are "drugs such as Vicodin (hydrocodone), OxyContin (oxycodone), Opana (oxymorphone), and methadone."
But there are plenty of other brand names that are being abused:
- Oxycodone formulations: brands include Oxyfast, Percolone, and Roxicodone
- Oxycodone combined with other medicines: brands include Endocet, Percocet, Percodan, and Xolox
- Hydrocodone: brands include Lortab, Tussionex, and Vanacet
U.S. 'Awash' in Prescription Painkillers
In 2010, pharmacies sold enough of these opiate-based prescription drugs to give everyone in the U.S. a typical 5-milligram dose of hydrocodone every four hours for one month.
"Right now the system is awash in these dangerous drugs that get people hooked and keep them hooked," Frieden says. "Essentially these are narcotics: dangerous drugs prescribed by doctors."
Who is taking all these pills? Abuse is more common in men than in women; non-Hispanic whites more than in other races or ethnicities; in rural more than in urban neighborhoods; and in middle-aged more than younger or older adults.
States with poorer prescription-control laws tend to have more deaths from prescription drug abuse. Not surprisingly, states with the most painkiller sales per person have the most deaths.
Frieden says specific actions are needed:
- States should monitor who is prescribing drugs and for whom.
- States should take measures to keep people from shopping for doctors who will more freely prescribe painkillers.
- Standard painkiller prescriptions should be for three days.
- Narcotics should be the last resort for pain control.
"We are in an epidemic of prescription drug overdose," Frieden said. "This epidemic can be stopped. We are optimistic that when states get serious, they can shut pill mills, stop inappropriate prescriptions, and halt this epidemic."
Joining Frieden at the news conference was U.S. "drug czar" R. Gil Kerlikowske, director of the Office of National Drug Control Policy.
Kerlikowske said that the White House has set a goal of reducing prescription drug abuse by 15% by 2015. But he said this progress would not come at the expense of people who truly need prescription painkillers.
"We don't want to turn the clock back to see people who need these medications not get them," he said.
既然3%的醫師開出了62%的鎮痛藥處方，大部分美國醫生不常開鎮痛藥處方。怎麽能得出“快成美國醫生的習慣了”這種結論？
說起這種藥，說實話，快成美國醫生的習慣了。肚子疼，頭疼，屁股疼，哪兒疼都是這種藥。美國醫生象從生產線批量生產出來的機械化產品。