Thirty years ago when I was at the end of a nasty 10 year addiction to alcohol and drugs, I was surrounded by a cadre of well-meaning and, some not so well-meaning doctors willing to write prescriptions for me long after it became clear I had a problem with pain medications.

All of them were well aware of my addiction history, had fallen prey to an addict’s persuasiveness, and were giving me medications they knew I was using to treat an active addiction. Two of them were in possession of a letter I had written asking that the next time I showed up in their offices looking for a prescription they were to say no and show me the letter. Neither of them did, and both continued prescribing—albeit less frequently. Why?

A lack of awareness

There were a number of reasons: The first was that this all occurred in the 1970s and 80s, when the awareness and understanding of substance use disorders was not what it is today. The second was my standing in the city of Boston, because of my family, which made it less likely that those in positions of authority would hold me accountable. And third, doctors who are confronted with a patient in profound distress want to treat that distress, and sometimes giving a drug addict what they need seems like the best way to ease their pain.

"More people now die every day from drug overdoses than from traffic crashes, and the majority of drug overdose deaths are caused by prescription opioids and heroin."

Today we know more about this illness, and physicians who are on the front lines as health care providers are more willing to confront addiction when it walks into their waiting rooms. Practitioners also have more knowledge and options for treatment alternatives. But, there is still a profound lack of education and understanding in the medical community when it comes to this top public health issue.

A web of opportunity

There is also the internet, which makes it easier for anyone to obtain prescription drugs online. We have allowed the pharmaceutical industry to create new and unnecessary drugs that are profoundly habit forming, with no more than a financial slap on the wrist as a penalty—a penalty that these companies have already allowed for in their marketing budgets.

More people now die every day from drug overdoses than from traffic crashes, and the majority of drug overdose deaths are caused by prescription opioids and heroin. Overdose deaths involving prescription pain relievers rose more than 300 percent from 1999 through 2011, leading the Centers for Disease Control and Prevention (CDC) to declare these deaths an epidemic.

In 2011, the Obama administration released the Prescription Drug Abuse Prevention Plan, outlining strategic steps for a “whole of government” approach to combat prescription drug abuse and overdose. New rules were finalized, making it easier for consumers to dispose of unused prescription drugs. Medicare enhanced its oversight of Part D utilization of these drugs, the Substance Abuse and Mental Health Services Administration released a toolkit to help communities combat opioid overdose, and the CDC conducted new analysis on the variation in opioid prescribing among states.

A plan to prevent prescription drug abuse was initiated requiring that high-risk beneficiaries obtain controlled substances only from specified providers and pharmacies. And, $5 million was proposed to improve the integration of Prescription Drug Monitoring Programs with health information technology.

The administration is doing its part. What is needed now is a commitment to educate our physicians and hold drug companies responsible for the drugs they put into the marketplace.