The untimely death of Prince shocked music fans from across the world and served as a sad reminder of the dangers of prescription medication. Prince may soon join a long list of celebrities such as Heath Ledger, Bobbi Kristina Brown, Michael Jackson, and Brittany Murphy, just to name a few, whose deaths have been linked directly or indirectly to doctor prescribed medications. And, this is not just a problem limited to the rich and famous. According to the Center for Disease Control and Prevention, since 1999, the number of overdose deaths linked to opioids, which include prescription pain relievers, has nearly quadrupled. Furthermore, the CDC states that overdoses from doctor prescribed pain relievers have been a major factor in the increase in overdose deaths over the past 15 years. While the number of pain relievers sold in the U.S. has almost quadrupled, the number of Americans reporting pain hasn’t necessarily increased. Those prescription opioids include drugs such as oxycodone, hydrocodone, and methadone.
Now the Food and Drug Administration will consider requiring doctors who prescribe pain relievers such as OxyContin to take safety training courses – this after regulators revealed that the number of doctors who completed voluntary training programs was less than half of what the FDA had targeted. The FDA put a risk-management plan in place several years ago in an attempt to curb prescription drug abuse, specifically long-acting pain relievers. Under the current risk-management program, drugmakers voluntarily fund training for doctors and drug safety. But FDA advisors say these policies and programs do not do enough and that the safety training should be mandatory. The CDC has recently instituted new guidelines to restrict and track opioid prescriptions. In 2014, more than 28,600 people overdosed on opioids in the U.S., which was the highest number in recorded history. Nearly 19,000 of those overdoses were from prescription pain relievers. The FDA initially suggested that doctors track patients taking long-acting pain relievers through a national registry. But the industry did not go along with the idea, stating that it would be too taxing on doctors and leave many patients undertreated by unfairly targeting those who rely on pain relievers to cope with long-term pain. So the FDA settled on a program that required patients to receive pamphlets about the risks of prescription drug abuse, along with the drugmaker-funded optional-physician training program. Critics of this risk-management program say these measures have not had a deep enough effect on prescription drug abuse or overdoses.
As an estate planning attorney, I have worked with many families who have a parent, spouse, child, or sibling who has been struggling with prescription drug addiction. Unlike illegal drug addiction, prescription drug addiction sometimes goes unnoticed or unaddressed by family members because either family members believe their loved one is getting the help they need, or family members don’t see the issue or they choose not to confront it. When family members are aware of illegal drug addiction, we can set up certain trusts to prevent individuals from getting the disposable money that would otherwise be available to that person for purchasing those drugs. Unfortunately, with prescription medication, a lot of times, that person is under a doctor’s care and is purchasing medication largely with prescription drug coverage as part of his or her medical insurance. Therefore, the medication may not be taking a financial toll. In comparison to someone who is spending $3,000 per month to feed an illegal heroin addiction, he could instead get oxycodone prescribed from his doctor for as low as $10 per month at his local pharmacy. Even if a trust is set up to prevent that person from using his money to purchase drugs on the street, he could easily save enough money to cover his monthly pharmacy bill.
Estate planning is more than just deciding who gets your money, house, and cars when you die. It is also about setting up contingencies and safety nets for you and your loved ones while you are very much alive. Proper planning, along with addressing difficult family issues, such as prescription drug abuse, are important to consider when deciding not only who will take care of you when you cannot take care of yourself, but also, who is going take care of your loved ones when they can no longer manage their affairs safely. Recognizing this growing epidemic in America, which could affect any family, is vital to maintaining your comprehensive estate plan. Burying your head in the sand and hoping that it will work itself out is not a working solution. Addressing the elephant in the room, while sometimes difficult, is essential for setting up a responsible estate plan, because once you or a loved one is gone, it is too late.