Who Should Control the Distribution of Pain Pills?

A pharmacist counts out pills.

Recently, the drugstore chain CVS announced that in some situations, it would limit the number of pain medication pills it would distribute. The chain stated that it would limit first-time opioid prescriptions to seven-day supplies for new patients suffering from acute ailments. For example, a person who has just gone through minor surgery, sprained an ankle or had a wisdom tooth removed would be able to receive no more than seven day’s worth of pills.

Why are they making this change? The CEO of CVS said that the company has often been asked to fill prescriptions for 30 to 60 of these powerful, addictive pills when the patient had a condition that called for a much smaller number.

Will other drugstores follow suit? It remains to be seen. However, some hospital emergency rooms have decided to avoid offering opioid painkillers to their patients whenever possible. In New Jersey, St. Joseph’s Regional Medical Center uses opioids only as a last resort, relying on non-drug or non-opioid methods of pain relief in as many cases as possible.

Early 2017, the CDC Also Got Into the Act

In early 2017, the Centers for Disease Control and Prevention (CDC) issued new opioid prescribing guidelines intended to reduce the number of pills being handed out to patients. The CDC noted, “The amount of prescription opioids sold to pharmacies, hospitals, and doctors’ offices nearly quadrupled from 1999 to 2010, yet there had not been an overall change in the amount of pain that Americans reported.” Their guideline publication also observed, “nearly 2 million Americans, aged 12 or older, either abused or were dependent on prescription opioids in 2014.”

The CDC advised prescribers to “Start low and go slow” —in other words, start with the lowest effective dosage of opioid painkiller and use great care when increasing it. While the CDC cannot order doctors to follow these guidelines, they were a welcome contribution to a disastrous situation of addiction and overdose.

The CDC also issued guidelines for patients themselves on how to avoid addiction to painkillers and what expectations they should have as they go through opioid therapy. Patients were advised to know all the other options they had for managing pain other than opioids, and expect their doctors to only “prescribe opioids only when their benefits outweigh their risks.”

Another Point of View from U.S. Rep. Roger Marshall

U.S. Representative Roger Marshall greets constituents.

In September 2017, U.S. Representative (Kansas) Roger Marshall, a medical doctor, also weighed in on this problem. He stated that he had “never seen a worse tool” than asking a patient to rate their pain on a scale from one to ten. He placed the responsibility for solving our crisis in the doctor’s office, with doctors and nurses both understanding the potential for addiction whenever opioid painkillers are involved in patient care.

Should We Include Parents?

According to a 2012 survey of teen attitudes toward drug use, what parents say to their kids about drug or alcohol use carries a lot of weight. Teens who reported that their parents WOULD NOT be “extremely upset” to learn that they were drinking or smoking marijuana were about four times as likely to use these drugs as teens who reported that their parents WOULD be upset. The obvious conclusion one could draw here is that parents should be using every tool at their disposal to educate their children on the dangers of drugs and be insistent that there be no drug use or underage alcohol use by their kids.

Father and son enjoy quality time.

So Who Should Really Be in Control?

Here’s the best answer: Every single professional and nonprofessional mentioned above should be involved in controlling the distribution of opioid painkillers. The scope of our opioid epidemic is so vast and so many lives are being lost that truly, it will take work on many fronts to defeat this enemy.

As individuals, we must seek non-opioid pain relief for ourselves and others we are responsible for, such as our children. Our professionals must retrain themselves on updated guidelines for prescribing. Professional organizations such as drugstores and hospitals can support that effort by being vigilant. Parents must take up the banner for sobriety and healthy lifestyles and set good examples for their children. Only by being dedicated to a common purpose can we all work together to help our country and our countrymen recover from the harm excessive opioid prescribing has already done.


Karen Hadley

For more than a decade, Karen has been researching and writing about drug trafficking, drug abuse, addiction and recovery. She has also studied and written about policy issues related to drug treatment.