Scott Mooneyham: Drug-abuse epidemics a century ago ... and today

  • Posted: Monday, April 15, 2013 12:15 a.m.

RALEIGH — In Harper Lee’s classic novel “To Kill a Mockingbird,” Mrs. Henry Lafayette DuBose is both Southern lady and moody morphine addict.

It would be easy to imagine today that the fictitious Mrs. Dubose was an anomaly, a character only marginally tied to time and place.

In the South into which Lee was born, she was not.

Documents and reports from the 1910s and 1920s show that towns like Durham; Knoxville, Tenn.; and Shreveport, La., likely had hundreds of morphine addicts among their populations. The typical morphine addict was a white, middle- or upper-class woman, often a widow, usually prescribed the drug to treat arthritis or other pain-inducing disease.

The federal government eventually began cracking down on what was then described as an epidemic of morphine and opiate-based medicine addiction, restricting how the drugs were distributed and prescribed.

Nearly a century later, the epidemic has returned. The medicines carry different names — OxyContin, Percocet, Vicodin — but are still opiate-based drugs.

Since 1990, unintentional drug overdoses in the United States have increased by 500 percent, with most of the increase attributed to prescription painkillers, according to the Centers for Disease Control. Since 2003, more people have died from opiate-based prescription drugs than heroine and cocaine combined.

Not so surprisingly, the increase in overdose deaths has been accompanied by a huge rise in the prescribing of the drugs. From 1999 to 2010, the amount of opiate-based narcotics prescribed by American doctors tripled.

North Carolina lawmakers’ response to the problem has been to create a prescription drug database intended to prevent addicts from doctor shopping (seeing multiple doctors) and others from unwittingly increasing dangerous medications.

One of the problems with the database is that only a small percentage of doctors and pharmacists have been using it. SBI agents, involved in specific investigations, can look through the records as well.

Legislation that is being considered by the General Assembly attempts to improve the effectiveness of the system by speeding up the reporting of prescription drug purchases. It would also encourage the state Department of Health and Human Services to use the database to report back to doctors and licensing boards about potential prescription misuse.

The changes may help busy doctors discover patients who are seeking multiple prescriptions to feed addictions; it may also help find doctors who are acting as enablers to addicts and involved in a pattern of prescribing large amounts of painkillers to patients known to be addicted.

But it is worth considering that the information plug into the database involves individual health care records, and a lot of prescriptions have nothing to do with the painkillers that are subject to abuse.

Now that the state has the database, there will be more attempts to allow more eyeballs to see the information, undermining individual privacy rights.

Meanwhile, the real problem is the same one that existed in 1920: Too many powerful drugs being handed out too often to too many people, and other people making money off of that proposition.

Scott Mooneyham writes about state government and politics for Capitol Press Association.


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