Brennan would disagree with that characterization. Neither she nor Kolodny is calling for an outright ban on prescribing opioids for chronic pain, but they would like to see them used only as a drug of last resort—and only with careful monitoring by a physician trained in addiction-risk management. They want patients properly informed about the drugs’ dangers, and prescriptions tracked in a way that allows both health and law-enforcement professionals to monitor the use—and abuse—of these powerful medicines.
The White House has called for a new opioid-risk-management plan for doctors by the end of this year and for prescription drug monitoring programs in all 50 states by 2014. As More went to press, 37 states had some sort of monitoring program in place; 11 had passed legislation authorizing such programs, but they were not yet up and running.
BRIDGET BRENNAN WANTS TO MAKE SURE her prosecutions matter in the widest possible sphere. It’s all part of what she calls a holistic approach. In addition to mandatory physician training, better monitoring and stronger legislation, her wish list includes, not surprisingly, a vigorous public education campaign—not only about how to use opioids wisely but also about how to dispose of unused pills safely (for tips, go to more.com/drugs).
Even as she targets a more elite type of dealer, the “pill mill” doctor who dispenses misery instead of succor, Brennan is already thinking ahead to the collateral damage, brainstorming with her network of rehab providers and law-enforcement colleagues on how to help the patients of the physicians she’s about to bust. The team decides to ask the city health department to create flyers to hand out to patients as the doctor is taken away.
“We wanted to make sure we had something tangible to give the people who were in the office that day,” says Brennan. “Information on where they could go for treatment. That’s what I mean. You don’t just make your arrest and that’s the end of it.”
I ask Brennan if she would call herself a crusader on the prescription drug issue. “Crusader?” she wonders. “See, I won’t consider myself a crusader on any issue because I’m always a little skeptical. I never go all the way over to the edge. However, I would say on this topic, I feel like I’m a voice out in the wilderness. Like I’m shaking people and saying, ‘Wake up. Don’t you see what’s going on?’ ”
*UPDATE: On May 3, 2012, the board of directors of the American Pain Foundation voted to dissolve the organization. The announcement on the organization's Web site cites economic difficulties. On May 8, the Washington Post reported on the launch of a Senate Finance Committee investigation into "the relationship between makers of narcotic painkillers and the groups that champion them," adding that it was unclear whether the group's announcement was related to the investigation.
UPDATE: In July 2013 the CDC announced that prescription painkiller overdose deaths among women had risen more than 400 percent since 1999 (compared with 265 percent among men). The report said that women ages 45-54 have the highest risk of death.
Nanette Varian is a features editor at More.
To learn how to dispose of unused drugs safely, click here.
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