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Successful, brief interventions,


such as motivational interviewing, can reduce prescription drug misuse and abuse. Additionally, policies regu- lating disposal of unused prescription medications can further limit distribu- tion. More research should be done on identifying and better understanding the behaviors of specific subgroups of pain medication users. A New England Journal of Medicine


study published in 2016 found no sig- nificant association between opioid outcomes and state legal restrictions. Texas enacted its prescribing monitor- ing system in 1997, and according to Health Affairs had death rates of fewer than three per 100,000 population. A 2014 study published in the journal Injury Epidemiology estimated drug overdose mortality increased during 2016–17 at 16.1 deaths per 100,000 population with a decline later. Al- though current literature disagrees on the outcomes of prescription drug monitoring programs on overdose deaths across all states, Texas needs to recognize opioids as a public health issue and keep its monitoring and sur- veillance systems in place. As a physician resident working alongside attending physicians and public health leaders, I observed dif- ferent philosophies with pain manage- ment. Although pain is subjective and should be treated individually, with this urgent epidemic in mind, guide- lines must be respected. There should be a concerted effort in educating the public and medical professionals, as well as developing policies. Training in opioid prescription and


treatment should begin early and con- tinue. Our medical graduates should be trained to deliver the best care to our patients and address this taboo without any reservations. n


EMILIE Y. PROT, DO, is a resident in the Texas Department of State Health Services De-


LAW FIRM PC


partment of Preventive Medicine and a member of the Texas Medical Association Council on


Health Promotion. EMILIE BECKER, MD, Medic- aid/Children’s Health Insurance Program mental health director at the Texas Health and Human Services Commission, contributed to this article.


12 TEXAS MEDICINE September 2016


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