Prescription drug abuse leading to spike in opiate-related deaths
Prescription drug abuse is on the rise, with Arizona ranking sixth in the nation for prescription drug overdose deaths, according to a new report by the Center for Disease Control and Prevention.
The CDC’s 2013 Prevention Status Report shows that for every 100,000 residents in Arizona, 17.5 died from prescription drug overdose in 2010. According to the same report, three-fourths of all prescription drug abuse and deaths are from opioid painkillers such as oxycodone or hydrocodone.
Dr. Trupti Patel, deputy chief medical officer at the Arizona Department of Health Services Division of Behavioral Health, said the rise of prescription drug abuse is an epidemic.
“It follows suit with how many opiate-related deaths we’ve seen,” Patel said. “Pain has been touted as the fifth vital sign. There’s been a major push in the past 15-20 years to aggressively treat pain, so that’s possibly one reason why there’s been an increase in narcotic prescriptions.”
Data collected by the Prescription Drug Monitoring Program reported that 10 million class II-IV prescriptions were written in Arizona last year, with 524 million pills dispensed. Half of those dispensed were opioid painkillers.
The CDC reported that opioid painkiller sales have quadrupled since 1999. Coinciding with the rise of prescription drug abuse and deaths is a sharp spike in heroin deaths. In 2009, the Arizona Department of Health Services reported 57 deaths. In 2011, that number more than doubled to 120.
Prescription painkillers are opioid narcotics derived from the opium poppy, which active ingredient is used to make morphine and its derivative, heroin. Heroin and prescription opioids like codeine share the same chemical composition, said Carrick Cook, drug recognition expert and public information officer at the Arizona Department of Public Safety.
“With their bodies developing addiction and the similarity of the drugs, it’s presumptive to assume that the next transition would be toward heroin,” Cook said.
Phoenix Police Department spokesman Sgt. Tommy Thompson said people turn to heroin when they can no longer obtain prescription painkillers or when the pills become too expensive.
He cited a case in which a young man who was on the baseball team of an Arizona state college was receiving discounted access to prescription painkillers while he was on the team.
“Once he was unaffiliated with the team, he couldn’t afford his prescriptions anymore, so he turned to heroin,” Thompson said. “It’s stronger and cheaper.”
College students are particularly susceptible to prescription drug abuse. According to the American College Health Association’s Spring 2013 National College Health assessment, 8 percent of undergraduate students nationwide have abused prescription painkillers not prescribed to them over the past 12 month, up from 7.4 percent in fall 2011.
Rates of abuse are even higher at ASU. The ACHA’s report on ASU showed that 9.4 percent of ASU students abused prescription painkillers not prescribed to them over the past 12 month. An additional 12.7 percent had abused prescription sedatives like Valium or Xanax, and stimulants such as Ritalin or Adderall, over the past 12 months.
According to a recent study, the Substance Abuse and Mental Health Services Administration found that people aged 12 to 49 who had previously misused prescription painkillers were 19 times more likely to initiate heroin use than their peers who had never used prescription painkillers.
The report also showed that 79.5 percent of recent heroin users had previously used prescription painkillers. Availability of heroin has seen a dramatic increase, particularly in the southwest where the substance is trafficked across the US-Mexico border.
In the 2013 National Drug Threat Assessment Summary, the Drug Enforcement Agency reported that the amount of heroin seized at the southwest border each year increased 232 percent since 2008.
Arizona is trying to quell the rise of both prescription drug abuse and heroin deaths through a mix of increased law enforcement, education and treatment.
In addition to investigating and enforcing prescription drug laws, the DEA sponsors a “Prescription Drug Take Back Day” on which Phoenix residents are encouraged to drop off their unused or expired prescription drugs at secure locations. According to the DEA, the last Take Back Day brought in over six tons of medications that were subsequently confiscated and incinerated.
Patel said the Arizona Department of Health Services is working on a set of guidelines for prescribing opiates that will be sent out to all physicians in the state by the end of July.
“It’s certainly a step in the right direction, but there’s no single answer,” Patel said. “I think we have to work with the patients, with the providers, and with the families to get these people treated and get education out to the public as to what a problem this has become.”
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