Roughly 4 million Americans too disabled to work are prescribed heavy-duty painkillers, such as OxyContin, Vicodin, codeine and morphine, according to a new study from the Dartmouth University School of Medicine in New Hampshire.

The study also found that one in five of those prescriptions are for doses so high that they put patients at risk for serious side effects and even overdose.
Plus, it's not even clear that the drugs help.

"We don't know whether that practice is safe, and we don't know if it's effective," said Michael Von Korff, an epidemiologist with the Group Health Research Institute in Seattle, who was not involved in the work.

The Dartmouth study examined the prescription records of the 9 million Americans who receive Medicare benefits because they have become too disabled to work — largely because of muscle or joint pain.

Some of those prescriptions are certainly necessary, but other patients would likely do better with a combination of physical therapy, exercise and non-drug treatments, Von Korff said.

"Almost half — over 40 percent — filled a prescription for opiates in a year, and one in five was filling six or more prescriptions per year," said Ellen Meara, an economist and associate professor at Dartmouth, who helped lead the research.

Lungs living outside the body

Creamy-pink and glistening, they lie on a stainless steel exam table — this pair of lungs inflating and falling in a rhythmic, ghostly pattern.

At the University of Michigan, researchers are pushing the limits of medicine, eking out new ways to boost the numbers of organs that are available to thousands of patients who die every year waiting for them.

That means, for a time at least, keeping human lungs — particularly delicate organs — "alive" outside the body.

"I've been in medicine for years, and I still think it's wild ... almost science fiction," said Dr. Paul Lange, medical director of Gift of Life Michigan.

It's also an unprecedented collaboration — the University of Michigan, Gift of Life Michigan and Henry Ford and Spectrum health systems — now poised to become part of a national clinical trial using a $250,000 piece of equipment purchased by Gift of Life, the organization responsible for recovering and delivering organs at eight sites around the state.

It's the kind of round-the-clock logistics work in which minutes matter.

"Outside the body, without blood and oxygen, those cells start deteriorating quickly," Lange said.

With the XVIVO Perfusion System, or XPS, doctors hope to keep lungs sustained outside the body long enough to give them more time to determine whether the organs are viable for transplant. If all goes well, the lungs eventually could be kept viable for days — giving them time to heal before transplant, doctors say.