With new Pa. drug laws, one academic wary of an over-correction

A comprehensive and rational drug policy in Pennsylvania may be elusive for some time, warns one academic.

State lawmakers have considered a few different remedies to address the spiking rates of heroin overdoses in Pennsylvania. In the next few weeks, they’ll turn their attention to the abundance of painkillers. If abused, such opioids can turn people on to heroin.

Proposals before the House and Senate would expand efforts to track prescription painkillers – the doctors who prescribe them, the pharmacists who fill the scripts, and the patients who take the drugs. A trade group for medical professionals has been lobbying hard for the measure for more than a year.

Supporters say the database can track “pill scammers” – patients who hop from doctor to doctor to obtain more medication. The expanded system can also monitor doctors and pharmacists who run their practices like “pill mills,” prescribing or dispensing medication recklessly.

“There does need to be a centralized database,” said Philippe Bourgois, a University of Pennsylvania professor of anthropology and community medicine.

But he cautions that monitoring alone won’t kill the connection between opioid abuse and heroin overdoses. Say the database works just as it should: a doctor looks up a requested prescription, and finds that the patient has been shopping around frequently for painkillers. What’s the next step? Is the patient cut off?

“Basically, that is condemning that person to going to the street corner and buying powder heroin and learning how to inject it, which is 10 times more dangerous than taking the over-the-counter drug,” Bourgois said. “Doctors that have made the mistake over overprescribing this drug need to be held responsible and need to help their patients wean off it in a realistic, sane way.”

“The danger, of course,” Bourgois added, “is that we’re going to — in our tradition of swinging from one righteous hysteria to another — is we’re going to swing the other way. And all of a sudden, people with chronic back pain are going to be distrusted and are going to be tortured by having to live with chronic back pain because the doctors are going to think that they’re actually drug users.”

State lawmakers have passed other measures intended to address heroin use. The governor is expected to sign a bill to grant immunity for certain low-level drug crimes to people who call law enforcement or emergency workers to report an overdose. The same measure would expand access to an antidote to heroin overdoses.

Bourgois said reducing deaths from heroin overdose will require something more simple — attention from the professionals in medicine and social services who work with potential addicts.

“It’s a great moment for a rebalancing,” said Bourgois.