blog-photo-lg04Has the line between legal “therapeutic prescription drugs” and illegal “street drugs” become so faint that either will do?

You could make a strong argument that the historic distinction now has minimal importance among American “consumers” looking for a high at the best price and from the closest source.

News accounts of actor Phillip Seymour Hoffman’s death from heroin overdose focused attention briefly on the rapid increase in heroin-related deaths in the last several years. The over-prescription of pain medicines like OxyContin, which began selling in the mid-‘90s, has led to increasing numbers of American prescription drug addicts who have switched to heroin either because prescription opioids became increasingly difficult to obtain from a doctor or simply because heroin often is less expensive and easier to access.

A study published by the New England Journal of Medicine found that heroin use more than doubled in the past decade, and research from the National Drug Intelligence Center shows heroin use up 79 percent from 2007-to-2012. Drug overdoses are now the leading cause of accidental death in the United States.

A huge increase in deaths from drug overdoses “has been driven,” according to the CDC “by increased use of a class of prescription drugs called opioid analgesics” − drugs such as hydrocodone (Vicodin, Norco), hydromorhone (Dilaudid, Exalgo), oxycodone (Oxycontin, Percocet), and morphine (Astramorph, Avinza).

People who suffer from pain go to their doctor for help. Doctors, attempting to alleviate the pain, which may be mild or more severe, then prescribe opioid painkillers. Either people take all of the medicine, perhaps even getting refills (or getting multiple prescriptions) until they are addicted, or they do not finish the medicine and it lingers in medicine cabinets across the country where it can be found by family members, friends, and anyone else with access in the home.

In fact, a hundred Americans die of overdoses every day.

As experts try to explain the epidemic and look for methods of reducing the problem and helping the addicted, most of America seems unaware of the scope of the problem ( In fact, more Americans die of overdoses every day (100) than are killed in car crashes (in the 90s and declining). More Americans die every year from prescription opiate overdoses (16,000 in 2010) than are killed in gun homicides (10,000 annually). If we lost 100 Americans a day to subway crashes or factory accidents there would be outrage and a search for a solution to the problem. But there is no such outrage.

Who is addicted? The addicts are not always the ones you would expect. Large numbers of women struggle with prescription drug addiction and many insured middle-class people get hooked after going to the doctor for muscle and/or back pain. Four-in-five of today’s heroin users began with prescription opioids according to a study at Drexel University’s School of Public Health.

Moreover, poly-substance abuse (with prescription drugs, illegal drugs, and alcohol all in the mix) has become common, making addictions more serious and treatment efforts more complicated.

It is a huge problem for business.

The number of employees testing positive for prescription opiates is increasing dramatically. Research by Quest Diagnostics, a provider of workplace drug tests, shows that the positive rate for prescription opiates among employees increased 40 percent from 2005-to-2009 and has continued to rise each year. Workers tested after accidents were four times more likely to have opiates in their system than those who were tested on a preemployment basis.

Working Partners/Cardinal Health offers a free video on employee prescription-drug abuse.

Institute member Working Partners of Columbus, Ohio has developed (with funding from the Cardinal Health Foundation and the Ohio State College of Pharmacy) the new video A Dose of Reality targeted at employees with the goal of enlisting American workers in recognizing and combatting the prescription-drug problem.

View the video at: and share it with your employees.

We are seeing some progress in the form of improved labeling of prescription opioids and awareness campaigns that target employees directly. The Working Partners video can be a very useful tool in this regard and an important component of your company’s employee education and awareness program. We have to drive home to employees the message that prescription-drug use can − and does − easily spiral out of control and can be a killer.

Mark A. de Bernardo