Pennsylvania is facing a massive public-health crisis

The opioid and heroin addiction that has rocked our nation continues to tighten its grip on communities of all types in our state — rural, urban and suburban enclaves that dot southeastern Pennsylvania.

One headline after another in this newspaper shows that the portrait of drug addiction has changed and affects people from all walks of life.

No longer should prescription opioid or heroin abuse conjure up only images of scary dealers on street corners in devastated neighborhoods. The addiction to these powerful narcotics is helping fuel a heroin epidemic that is evident in every community.

The question is what, exactly, can be done to help combat this crisis? To get to at least part of that answer, we need to understand that this is as much a pub- lic-health challenge as it is one for law enforcement.

One important possibility is prescribing non-opioids as the preferred option for chronic pain. Medical professionals must be educated about the effective and safe alternatives to opioid painkillers that are available right now, including low-dose nonsteroidal anti-inflammatory drugs (NSAIDs). These drugs are consistent with a draft guideline issued by the U.S. Centers for Disease Control and Prevention.

The data is alarming, particularly so in Pennsylvania:

• Our nation makes up approximately 5 percent of the world’s population but consumes almost 100 percent of the world’s hydrocodone and approximately 80 of its oxycodone.

• Twice as many Americans died from drug overdoses in 2014 than in 2000, with 61 percent, or 28,647, of those deaths involving heroin or prescription opioid painkillers like OxyContin.

• 259 million prescriptions were written for opioid pain relievers in 2012 — equal to one bottle of opioid pills for every American adult.

• In Pennsylvania, hospitalizations for overdoses due to pain medication increased 225 percent from 2000 to 2014, according to the Pennsylvania Health Care Containment Council.

• Drug overdose deaths in Pennsylvania increased by 12.9 percent from 2013 to 2014, compared to a 6.5 percent increase nationally.

Physicians in the U.S. prescribe opioids for a much larger range of conditions than anywhere else in the world and we prescribe an inordinate volume of these medica- tions. These prescriptions are often trafficked like illegal narcotics and can end up in the wrong hands. Once a patient becomes addicted to prescription opioids, they are more likely to move on to heroin, including young athletes managing pain from an injury or middle-aged professionals recovering from surgery.

An estimated three out of four heroin addicts reported abusing prescription opioids before switching to heroin. That is because heroin is less expensive and more accessible than prescription opioids.

Gov. Tom Wolf is conducting roundtable discussions across the state about this challenge, and is committed to ensuring all medical and dental students are taught safe addiction and pain management options before they’re licensed to practice.

Encouraging broader use of NSAIDs for appropriate patients could lower the risk of developing opioid addiction because NSAIDs are non-addictive.

The prescription opioid crisis requires a broad-based, multipronged response that should include educating healthcare providers and patients about effective alternatives to opioids. That includes a greater focus as well on ways to prevent people from abusing opioids in the first place.

Low-dose NSAIDs need to become a priority with prescribers as a first-line option for appropriate patients with chronic pain.

Dr. Clarence L. Young is the senior vice president and chief medical officer of Philadelphiabased Iroko Pharmaceuticals, which has developed and markets low-dose NSAIDs.