Dan Baker was a healthy, athletic, young man when he first enrolled at the University of St. Thomas in Saint Paul, Minnesota. Instead of drinking or partying, Dan spent his time playing baseball and hockey. While enrolled, he suffered a minor back injury and was prescribed opioid painkillers. At that time, he had no idea about the addiction and substance abuse that would ensue.
Dan’s parents first became aware there was a problem when his girlfriend expressed concern that Dan was shutting himself in his room and not attending class. Soon after, Dan’s parents began accompanying him to follow-up doctor’s visits, only to discover that Dan had been “doctor shopping,” a process whereby opioid addicts see different physicians to get the quantity and type of pain pills they desire. Dan’s family tried to help with his addiction, but they were unsuccessful. When Dan was no longer able to obtain prescriptions, he began to buy pills off the street.
Dan eventually enrolled in a rehab center in Granite Falls, Minnesota, where he found sobriety and employment; he later got a room at a halfway house in Rochester, Minnesota. This newfound sobriety was short-lived, however, because soon thereafter Dan was laid off from his new job and began experimenting with heroin. Dan re-enrolled in the rehab center but was kicked out after sharing medication with his roommate.
Dan’s family was vacationing in California when he called to inform them he had been kicked out of rehab, but he assured them he would be okay until the family returned home. Unfortunately, Dan was wrong. That evening, Dan and a friend bought heroin in Minneapolis and returned to the friend’s home in Maplewood, a nearby suburb.
The next morning, Dan’s parents flew back to Minnesota and, upon their arrival, received a message that Dan had died of a heroin overdose. A few years later, Dan’s father, Dave Baker, was elected to the Minnesota House of Representatives, where he is currently working to expand opioid addiction programs as a memorial to his son.
Another Minnesotan recently died of an opioid overdose; only this time, his death garnered national attention. In April 2016, the famous musician Prince was found dead in his home due to an overdose on the opioid fentanyl. Fentanyl is a dangerous drug, more potent than both heroin and morphine. Further, investigators have learned from family members that Prince had a decades-long history of opioid abuse, mainly Percocet, “to help him deal with the rigors of performing.” Investigators revealed that pills containing fentanyl were found in a bottle marked hydrocodone, and they believe the mislabeling caused Prince to unknowingly ingest the opioid.
Unfortunately, stories similar to Dan’s and Prince’s have become increasingly common across Minnesota and the nation. Since 1999, deaths from opioid overdoses have steadily risen and show little sign of slowing down. At the same time, the amount of opioid prescriptions has quadrupled, and in 2014, for the first time, deaths from opioid overdoses surpassed deaths from car crashes.
Why has this become a problem? For one, opioids are extremely addictive. Opioids increase dopamine levels in the brain, causing a person to experience more cravings. Overdoses occur when someone takes a dosage his or her body is not used to, which is why buying prescription opioids off the street is particularly dangerous, since no one can be certain of the dosage or purity of the drug. When an overdose occurs, an individual’s respiratory system shuts down, essentially causing the body to forget to breathe.
State and federal governments responded to this crisis with legislation aimed at curbing opioid abuse. Though well-intended, the current legislation may have developed a perfect storm for a crisis. This Note begins by providing a history of opioid usage throughout the world and outlining opioid regulations in the United States during the past century. Next, this Note examines statistics demonstrating the current state of opioid abuse. This is followed by an examination of the pain management standards from The Joint Commission on Accreditation of Healthcare Organizations (TJC), the recent guidelines from the Centers for Disease Control and Prevention (CDC), and the effect of the Affordable Care Act (ACA) on the opioid abuse epidemic. This Note then discusses current federal and state combative measures and analyzes the effectiveness of the patient satisfaction survey requirement under the ACA and TJC’s pain management standard. Finally, this Note will look at the effectiveness of both state prescription drug monitoring programs (PDMPs) and naloxone distribution programs. In sum, this Note argues that although current combative measures have had a positive impact on decreasing prescription opioid abuse, major change will not occur until patient satisfaction surveys are removed from the ACA altogether or penalties from low scores are lessened and TJC’s pain management standard is clarified.