The Prairie Doc Perspective

Oh! we got trouble

By Richard P. Holm MD

Trouble, trouble, trouble,

Oh! we got trouble,

Right here in River City!

With a capital “T”

That rhymes with “P”

And that stands for Prescription Drugs.

Proof of this trouble comes from South Dakota’s new Prescription Drug Monitoring Program or PDMP established by the South Dakota legislature in 2010. This tool is there to help prescribers and pharmacies know when a drug seeker is at the door falsely claiming a medical problem in order to obtain drugs to sell or abuse.

We know that in South Dakota 162 people have obtained separate prescriptions for narcotics from more than ten physicians/PAs/NPs over only 8 months, and 55 have tapped at least six prescribers for such meds using six or more different pharmacies.

We also know that since 2004, poisoning deaths in South Dakota from abuse or wrongful use of certain prescription drugs have averaged at 19 per year, mostly due to narcotics and opioids, and that number appears to be on the rise.

Still, appropriate prescribing of narcotic pain medicine provides for many an escape from suffering. Rest assured that physicians and care providers will and should prescribe pain relievers without hesitation when such medicines are needed to help people in trouble.

But with all that compassionate care comes excessive prescribing. In fact, the Prescription Drug Monitoring Program tells us that in the first eight months of this year in South Dakota there has been dispensed more than eleven million tabs of the specific medication hydrocodone with acetaminophen or Vicodin. That is 13 tabs for every South Dakotan. Other prescriptions for potentially abused medications commonly sold on the streets include zolpidem or Ambien, lorazepam or Ativan, methylphenidate or Ritalin/Concerta, and oxycodone with acetaminophen or Percocet, to name a few.

The harms from drug abuse extend beyond the illicit user to those living nearby. The surrounding community so exposed has increased crime and violence, child and spouse abuse, motor vehicle accidents, sexually spread diseases, fetal malformations in children, and deaths due to accidental and intentional overdose.

We’ve got trouble, trouble, trouble right here in South Dakota. This is a call to all physicians and pharmacies out there who are targeted by drug seekers. Do not fall for it. Use the PDMP, be aware of the danger to patients and society, and just say no when you should. And to those who are seeking illicit drugs, know that we are watching you.

Dr. Rick Holm wrote this Prairie Doc Perspective for “On Call®,” a weekly program where medical professionals discuss health concerns for the general public.  “On Call®” is produced by the Healing Words Foundation in association with the South Dakota State University Journalism Department. “On Call®” airs Thursdays on South Dakota Public Broadcasting-Television at 7 p.m. Central, 6 p.m. Mountain. Visit us at 

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