SOUTH BEND -- Dr. Todd Graham’s murder was a sobering event in the opioid epidemic. The doctor at South Bend Orthopaedics was shot and killed last summer by a patient’s husband for not prescribing opioid pain medication.

A week after Graham’s death, local doctors came together at a news conference with a promise to act. A promise to reverse the mistakes they made in helping create a reservoir of available opioid prescription pills.

“When Todd was killed, that galvanized everybody,” said Dr. Stephen Anderson, chief medical officer for Saint Joseph Health System. “I hate to say it, but it really took something like that to look at ourselves, our behaviors as prescribers and how that has contributed to the excess of narcotics in the community.”

Now it’s a struggle to balance the needs of patients who legitimately need the medication while changing prescribing practices to avoid creating a new generation of addicts. The epidemic, meanwhile, continues to grow.

Earlier this month, the Centers for Disease Control and Prevention released a report showing overdose cases had climbed by 30 percent at emergency rooms from July 2016 to September 2017. Indiana was at about 35 percent; the Midwest was the hardest-hit region, seeing a 70 percent increase in emergency room visits.

Locally, South Bend EMS used 494 doses of naloxone, the opioid-overdose antidote, in 2017, up from 338 doses the previous year. Overdose deaths in St. Joseph County did drop from 60 to 57 in 2017, but the total is still higher than the number of people killed in homicides and motor vehicle accidents combined.

But doctors appear to be changing their practices. The number of prescriptions in St. Joseph County has steadily decreased in recent years, totaling about 81 prescriptions per 100 people in 2016, according to the most recent data from CDC; that’s a drop from a 2012 high of 100 prescriptions per 100 people.

Many doctors admit they didn’t have the best prescribing practices. But they argue that they were also misled by opioid manufacturers and distributors about how addictive opioids were and whether they were the best option for treating chronic pain.

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