New Research Shows Promising ​​Reduction​​ In Tennessee Prescription Drug ​Use

Andrew Shinar meets a lot of people in pain. 

He performs hip and knee replacement surgery at Vanderbilt University Medical Center, and in 2011, he decided to start tracking how many of his patients coming in for joint replacements were taking painkillers. 

The state has historically had some of the country’s highest rates of addiction and death from prescription drugs, including narcotics.
In an attempt to address that problem, Tennessee passed a law in 2012 cracking down on prescription drug use, in part by requiring doctors to sign into a database every time they write a prescription. That way, they can see if the patient is already getting drugs from another doctor and address
“doctor shopping,” which can lead to drug overdose. 

Shinar’s
 new study shows some promising — though preliminary — changes over the past few years: In 2011, 37 percent of his patients said they were taking narcotics before they came in for surgery; in 2014, that number dropped to 19 percent. 

“It really seems likely that the new requirements are making a dent in the amount of narcotics that people are taking,” Shinar says.

What The Numbers Mean

It is possible, of course, that the drop is not due to the change in state law. Painkiller use among Shinar’s patients began to decline even before the law was passed — although, he says, doctors may have prescribed fewer drugs in anticipation of the new policy.

David Ragan with the Tennessee Department of Health says he believes the law change is part of the drop, but doctors and patients are also just more aware that painkillers can be dangerous.

“It hasn’t in the past been talked about a whole lot,” he says. “I think people are beginning to understand there is a problem here. “
Still, the problem is far from over.

In fact, even though data collected by the Health Department also shows prescription drug use is down in Tennessee, the
number of overdose deaths
is still rising. 

Shinar
notes that while he gives patients narcotics immediately after surgery, not everyone with chronic pain needs painkillers.

“In most of the world, treatment for it is not really with narcotics,” he says. “They’ll give anti-inflammatories
, they’ll give Tylenol, they’ll exercise and stretch and do physical therapy.”

And patients who are on painkillers before surgery are
more likely to experience pain afterward
— and need revision surgeries.