A significant number of people who overdose on drugs start their addiction with legal prescriptions for opioid painkillers. Oftentimes, the refill is what gets them hooked and craving more, experts say.

“First exposure is when the risk of addiction starts. But the second prescription, or the refill, is when the risk goes up tenfold,” said Mike Evans, chief pharmacy officer for Geisinger Health System.

Over the past few years, Geisinger has worked to cut opioid prescriptions in half by finding alternative means to treat pain. In some cases, Geisinger researchers determined painkillers make pain worse because they create more pain receptors.

“There is a facade that if a physician is prescribing a medication, it must be safe. Opioids are not safe. They are very potent and they are not the most efficacious for most pain,” Evans said.

For instance, most people who had a tooth pulled in the past likely received a prescription for an opioid, like Vicodin, while an over-the counter acetaminophen medication, like Tylenol, could be just as or more effective, Evans said.

Geisinger’s research also determined physical therapy proved more effective than medication for patients with lower back pain, a common ailment traditionally treated with painkillers.

Some people who become addicts transition from legal prescription opioids to illicit street drugs like heroin. Doctors who prescribe opioids are always on alert for this, Evans said.

Patients who are prescribed opioids submit to urine testing at unscheduled times, Evans said. If other controlled substances are detected, no opioids are prescribed, he said.

“We actually would be putting that person at risk of overdosing,” Evans said.

In 2016, Geisinger launched its #HadEnough campaign to spotlight the overuse and abuse of opioids, which is fueling a nationwide overdose crisis. The health care provider says it is continually looking for alternatives.

“Years ago, the way we faced pain management was far different,” Evans said.

Contact the writer: bkalinowski@citizensvoice.com 570-821-2055, @cvbobkal