The American Academy of Pain Medicine

Forty lives saved from ODs: Cheap at twice the price

By Perry G. Fine
Initially published in The Salt Lake Tribune - June 11, 2009

What's the value of a human life? No one can answer this age-old question, but thanks to the efforts of the Utah Department of Health, many volunteer health professionals and the state Legislature, we have learned how much it costs to save a life.

We know this from the results of a public health program launched two years ago to reduce the epidemic of accidental prescription painkiller deaths in Utah by improving physicians' pain-treatment skills and informing the public how to safeguard these medicines and to use them only as prescribed.

With an investment of $150,000 per year, the program has significantly reduced the death toll at a rate of $3,500 for each of the estimated 40 lives saved. That cost is about one-half of what, on average, every American spends on health care each year -- or less than one penny per Utah taxpayer.

Now that's quite a bargain, considering that it costs about $10,000 (a million pennies) per day for a bed in a hospital intensive-care unit.

Unfortunately, the state funding for this initiative runs out this year because, as everyone knows, our state's financial situation is tough, requiring very difficult funding decisions and cuts.

Hopefully, as our legislators analyze the results of this initiative and recognize its extraordinary value, they will decide to maintain funding for it.

But in the meantime, to the rescue comes our very own Sen. Orrin Hatch, who has introduced the National Pain Care Policy Act. This foresighted piece of legislation will provide federal funds for similar projects here in Utah and across the rest of the nation.

Compared to all of the controversial issues facing Congress, passage of this broadly supported bill seems to be a no-brainer. In fact it is, except that one person stands in the way, and he's a physician at that -- Republican Sen. Tom Coburn of Oklahoma.

For reasons that defy his Hippocratic oath, the good doctor (and senator) does not believe that the money we send to Washington D.C. should be spent on health education and research, or, if my interpretation of the record is correct, anything else that actually saves lives, even at a penny apiece.

It is important to note that the solution to the public health problem of prescription drug abuse and accidental overdose is not to withhold their use from patients who benefit from them. The pain-treatment drugs -- the opioids -- are irreplaceable for the patients who require them.

Rather, the evidence from the Utah experience shows that education -- professional and public -- is the best antidote for this deadly malady.

So, please join me in applauding Sen. Hatch for his efforts, and in supporting them, with the hope that perhaps he can persuade his Senate colleagues to see the light. For that light might one day shine on your son, daughter, mom or dad who may require surgery, have cancer, or suffer the many other causes of pain that require treatment.  

Perry G. Fine, M.D., is a professor of anesthesiology at the University of Utah School of Medicine's Pain Research Center.