Drug overdoses are in the news again with the passing of Philip Seymour Hoffman. The 46-year-old actor was found dead on Sunday in his Manhattan office-apartment of an apparent drug overdose. Investigators found a large quantity of heroin and prescription medications.
Heroin abuse is on the rise, and so is the abuse of a variety of prescribed narcotics, or opioids.
Overdoses linked to opioid-based prescription drugs, such as oxycodone, have more than quadrupled since 1999, according to the Centers for Disease Control and Prevention (CDC). It doesn't take a rocket scientist to figure out why.
"There was a fourfold increase in opioid sales between 1999 and 2010, which corresponds to our fourfold increase in overdose deaths involving opioid pain relievers," said Christopher M. Jones, team leader of the prescription-drug overdose team in the CDC's National Center for Injury Prevention and Control.
"I think the main takeaway is that we have seen a dramatic increase in the number of deaths involving opioid pain relievers that are quite different than what we see for illicit drugs or other prescription drugs — that the opioid pain relievers really stick out," Mr. Jones said at an Oct. 24, 2012, teleconference sponsored by the CDC. "They're involved in about 75 percent of all overdose deaths that involve a prescription drug."
There are other costs, such as the estimated tab of "$72 billion in direct health care costs related to opioid pain-reliever misuse and abuse," Mr. Jones said.
The dangers are so obvious that states have been enacting laws requiring patients who receive narcotic prescriptions to be periodically tested for their own and others' safety.
It makes so much sense to do this that the American Civil Liberties Union (ACLU), ever vigilant against reasonable public policies that might save lives, has sued the state of Indiana over a new law requiring patients on opioids to be tested at the beginning of treatment and thereafter once a year.
The test applies to patients who receive for at least a three-month period more than 60 pills per month or a daily dose that is the equivalent of 15 mg of morphine.
Given the surge in problems associated with opioids, a yearly test might not seem unreasonable to most people. However, the ACLU sees the requirement as a violation of the Constitution's prohibition of "unreasonable searches or seizures."
"The Fourth Amendment protects all of us from government-mandated searches unless there is cause or justification," said Kenneth J. Falk, legal director of the ACLU's Indiana chapter. "The mandatory drug testing simply goes too far."
The lawsuit, Wierciak v. Individual Members of the Medical Licensing Board of Indiana, was filed in U.S. District Court for the Southern District of Indiana on Jan. 8.
According to an ACLU press release, "The lawsuit was filed on behalf of James Wierciak, a Hamilton County resident who has been prescribed pain medications for at least 18 years in order to manage the chronic pain caused by a variety of health problems." Mr. Wierciak doesn't want to sign a form agreeing to an annual blood or urine test.
Many people suffer from chronic pain, and many have benefited greatly from the development of opioid-based drugs. The medical board's rule about a yearly test is designed to ensure minimal monitoring of these powerful drugs — not to take them away from patients who need them.
Indiana lawmakers authorized the state medical board to enforce the testing beginning in December 2013. The CDC has found that prescription-drug overdoses in the Hoosier State were associated with 14.4 deaths per 100,000 people in 2010, which exceeds the national average of 12.4 per 100,000. That puts Indiana in the upper third of states with an overdose problem.
Why the three-month dosage stipulation? A clue might be found in a statement by Dr. Jane Ballantyne, professor of anesthesiology and pain management at the University of Washington in Seattle, who told the aforementioned CDC panel: "Multiple studies, in fact, show that after 90 days of continuous opioid use, opioid treatment is much more likely to become lifelong. So patients that continue opioids beyond 90 days are less likely to be able to come off opioids than those that stop the treatment earlier."
In other words, patients become addicted, so medical authorities are being understandably cautious.
So, who would you trust on this — a panel of doctors or a gaggle of ACLU lawyers?
Inquiring emergency-room personnel want to know.
Robert Knight is senior fellow for the American Civil Rights Union.