Overdoses from Rx Drugs Soar

Legal opiates now tied to more deaths than heroin, cocaine combined
The Journal Gazette

FORT WAYNE – When most people think of drug overdose deaths, they think of overdoses from street drugs such as heroin and cocaine.

It would be more apt to think of the pills in our medicine cabinets.

New government figures show that the use of prescription narcotics – powerful opium-based painkillers that can be deadly when taken incorrectly – continues to skyrocket. Also, the number of overdose deaths involving painkillers has exploded to the point where fatal overdoses of drugs such as Vicodin, OxyContin and morphine now outnumber those caused by street drugs.

And the latest statistics show that Hoosiers’ use of these controlled substances continues to increase faster than the national rate, which also continues to climb.

“It is a public-health epidemic,” said Dr. Deborah McMahan, Allen County health commissioner. “It’s disheartening, because people are just doing it voluntarily.”

In December 2008, a Journal Gazette investigation showed that the use of narcotics was up dramatically in Indiana:

•Fentanyl use increased 744 percent in the 10 years ending in 2006

•Oxycodone use was up 712 percent

•Methadone use was up 2,061 percent – nearly double the national increase for methadone in that time period.

Now, U.S. Drug Enforcement Agency statistics show that in 2007, the use of these drugs increased again, and once again Hoosiers’ growing appetite for them outpaced the growth in the rest of the country.

In 2006, DEA figures showed methadone was being used at a rate of 2,384 grams per 100,000 people nationally; in 2007 that use leapt to 5,352 grams, a 125 percent increase.

But Hoosiers used methadone in 2007 at a rate of 6,127 grams per 100,000 people – up 138 percent from the year before. Those figures do not include methadone prescribed to break the addiction of other opiates, such as for heroin addicts.

McMahan said that alone – aside from the problems caused by overdoses or misuse – is frightening.

“People need to understand you’re going to have discomfort as you get older, especially if you don’t take care of yourself,” she said. “We want to medicate every symptom away and you can’t do that.”

And as our use of prescriptions has shot up, so has the number of fatal overdoses. More people die from accidental overdoses of narcotic painkillers than from any other type of drug, according to figures from the Centers for Disease Control and Prevention.

That trend is true locally, too: Pat Kite, Allen County Coroner’s Office investigator, said there were 69 accidental drug overdoses in 2007 and 2008, including cases of alcohol poisoning. Forty-two of those fatal overdoses – almost two-thirds – involved prescription narcotics.

“It is an increasing problem in our community,” Kite said.

And the problem is increasing even while most people’s concerns are elsewhere: Billions are spent to stop street-drug trafficking nationwide, and newspapers are filled with reports of drug busts and seizures. But in 2007, according to the National Vital Statistics System, prescription narcotics were involved in more overdose deaths than heroin and cocaine combined.

“The abuse of prescription drugs is our nation’s fastest-growing drug problem,” Gil Kerlikowske, director of the Office of National Drug Control Policy, said in a written statement announcing a June report showing that emergency-room visits for non-medical use of prescription narcotics more than doubled between 2004 and 2008.

Fatal mistakes

Unlike marijuana or cocaine, prescription narcotics are not coming in illegally from other countries by the plane or truckload. Instead, they’re bought at Target or CVS or Walgreens, after your doctor writes a prescription.

Many say it is that factor that adds to the danger.

“People have the perception that it’s a prescription drug, it’s approved by the FDA, so it’s safer than crack or whatever,” said Mary Hendrickson, director of quality/regulatory affairs for GENCO Pharmaceutical Services in Milwaukee. “They figure they or someone else had it prescribed by a doctor, so it’s safe.”

In fact, fentanyl – a drug so powerful it is meant for cancer patients who have developed a tolerance to morphine and is prescribed in micrograms instead of milligrams – is 80 times more potent than morphine and hundreds of times stronger than heroin. Even taking a second dose too soon could be a fatal mistake.

Hendrickson, who recently testified in a Senate hearing on prescription drugs, said people are often over-prescribed these drugs or do not use them all, and they sit in their medicine cabinet. That can lead to what the Drug Enforcement Agency calls “diversion” – theft or sale for recreational use because of the euphoria they cause.

“They hang on to (leftovers) thinking they might have a legitimate reason,” Hendrickson said.

Or, because they don’t know what to do with them. For decades people simply flushed leftover medicines down the drain or toilet. Now, a U.S. Geological Survey study of 139 bodies of water across the country found that more than 80 percent of the water samples were contaminated by prescription drugs.

The problem of people holding on to medications is so large that when the DEA held a medicine-take-back day in New Jersey, when anyone could bring in any prescriptions with no questions asked, more than 4 tons of drugs collected.

Now, the DEA is planning a national event for Sept. 25. As of Friday, drop-off locations were set for the Indiana State Police Post, 5811 Ellison Road, and the Van Wert County Sheriff’s Office in Van Wert, Ohio, but officials said new sites are being added regularly and will be listed at www.deadiversion.usdoj.gov/takeback/.

Hendrickson said her company, which processes out-of-date medicines, would like to handle narcotics as well, but it is illegal for them to accept controlled substances.

Because people have no way to get rid of them, she said, they stay in homes and become vulnerable to diversion.

McMahan said more attention must be paid to why people are so desperate for the high that opiates like OxyContin or Vicodin bring.

“You don’t see something of this magnitude if there isn’t a systemic cause. Why is everyone turning to this on such a massive scale?” she said. “It’s interesting how we can’t make it through life without being in Bubble Wrap.”