Prescription drug abuse and overdose is a problem that does not know ethnicity or social economic background.


• The Oklahoma State Department of Health recently announced Oklahoma is one of 17 states slated to receive annual awards over the next four years to implement prevention strategies to improve safe prescribing practices and turn the tide on the prescription drug overdose epidemic. The money will come from the Center for Disease Control. The funding is wonderful, but is it really needed? Doesn't the state already have laws and programs in place to address the issue of prescription drug abuse? Is this really a problem in Oklahoma and, more importantly, in this area?

The Oklahoma State Department of Health says the agency will receive $820,000 from the Center for Disease Control over the next four years to prevent overdose deaths related to prescription opioids (pain killers) as part of the Prescription Drug Overdose: Prevention for States program.

Funding will support:

• Prescription drug monitoring programs

• Improvements to opioid prescribing practices

• Prevention efforts at the state and community level

• ­Rapid response projects to address new and emerging problems related to prescription drug overdose ­The purpose of this compre­hensive program is to prevent prescription drug overdoses and deaths by addressing problematic prescribing and patient overuse, misuse, and abuse of prescription drugs. We will work with physicians, pharmacists, community groups, and numerous agencies to combat the problem," said Dr. Terry Cline, Secretary of Health and Human Services and OSDH Commissioner. "Some of the funding will be provided to the Oklahoma Bureau of Narcotics and Dangerous Drugs Control to enhance Oklahoma's Prescription Monitoring Program, a statewide data system that tracks all prescriptions for controlled substances, and to educate providers on using the system to improve patient care." Just how serious is the prescription drug overdose problem in Oklahoma? More importantly, how serious is it in this area?

Statistics show drug overdose is the leading cause of injury-related death, both in Oklahoma and the United States. In 2013, Oklahoma had the eighth highest age-adjusted drug overdose death rate in the nation. That's 49 percent higher than the U.S. rate. More overdose deaths involve prescription painkillers (opioids) than alcohol and all illicit drugs combined. The Ardmoreite

recently reported between 2007 and 2013, 4,600 Oklahomans died from unintentional poisoning of drugs and/or alcohol. Data collected by the OSDH between those same years shows Carter county ranked fifth highest in the state. Jefferson and Johnston counties also ranked above the state average.

District Attorney Craig Ladd says everyday he sees first hand how serious the misuse of prescription drugs is throughout the area. The top prosecutor says he welcomes more funding to support efforts to curb the tide of misuse and addiction.

"A new law and grant money being used to target our prescription drug problem is a great idea. As district attorney, I routinely receive carbon copied autopsy reports of unattended/unnatural deaths which occur in Carter County. Most people would be absolutely shocked if they knew how many people die in Carter County every year from prescription drug overdoses," Ladd says. "During my time as a prosecutor, I have noticed that we often go through different 'cycles' in the criminal justice system. At this time, we are clearly in a prescription drug abuse cycle which hopefully will diminish in size soon. There seems to be a notion that drugs which a person can obtain at the pharmacy are inherently less dangerous than street drugs. This is simply not true." Ladd also points out prescription drug abuse can not only destroy the life of the user, it can also result in the senseless and tragic death of others.

"Not only can prescription drug abuse cause fatal overdoses, it can also render people unable to safely operate a vehicle. Over the past few years, we have prosecuted an increasing number of first degree manslaughter cases where the drivers were under the influence of prescription drugs rather than alcohol or street drugs," Ladd says adding, "In years past, parents warned their children about the dangers of marijuana, cocaine, crack, meth and heroin. Now that I have a son in high school, those admonitions from me include an equal amount of emphasis, if not a greater emphasis, on the dangers of prescription pill abuse. I applaud the legislature for the passage of this law and its efforts to address this problem." What does the new law say and how is it expected to deter the misuse of prescriptions?

"House Bill 1948 takes effect on November 1st. This measure will man date that medical professionals check a patient's prescription history in the Prescription Monitoring Program prior to prescribing certain controlled prescription drugs, including opioid pain killers such as Hydrocodone and Oxycodone, as well as antianxiety benzodiazepines like Valium and Xanax," says OBN spokesman Mark Woodward. "These specific drugs were singled out because they are among the top five drugs associated with Oklahoma prescription overdoses. Nearly 80 percent of all drug-related deaths in Oklahoma involved at least one prescription drug." How does OBN intend to use a portion of the new grant funds?

"The grant funding provided to the OSDH will be used to address the prescription drug epidemic in Oklahoma, including helping fund on-going improvements and software upgrades to the PMP system for physicians to more easily identify patterns of prescription abuse and fraud. The grant will also help with rapid response programs for the public to administer Narcan (Naloxone) to reverse the effects of drug overdoses, and the funding will help educate physicians and the public about prescription drug abuse and safe disposal of old, expired medication." Ardmore Deputy Police Chief Kevin Norris says he hopes grant funds can be obtained by the Ardmore Police Department for rapid response.

"The Ardmore Police Department would like to receive a portion of the state's grant money; we believe this could be another vital tool to assist us in saving lives. I have been working with Mendy Spohn, Carter County Health Department Administrator, trying to find a grant to assist our department in the purchase of Narcan and for us to train each of our officers in the usage," Norris explained. " On a weekly basis our officers, along with medical personnel, respond to overdose victims throughout the city of Ardmore. If dispatched to a medical call, our officers are usually the first of the first responders on scene because they are already in the areas patrolling and taking calls for service. In overdose cases time is essential in saving lives, and if the officers had the Narcan they could administer the medicine sooner, hopefully saving the life." Spohn agrees first response is a vital piece to solving the prescription drug abuse puzzle.

"Opioid overdoses are an increasing problem, here as well as throughout the United States," Spohn confirmed. "The CDC funding is wonderful news. In addition, the Federal Office of Rural Health Policy has also recognized the problem and is offering the Rural Opioid Overdose Reversal Grant Program." Spohn described this additional potential funding avenue.

"It's a one-year program to fund efforts that will focus on preventing opioid overdose in rural areas. The purpose of the ROOR program is to reduce the incidences of morbidity and mortality related to opioid overdoses in rural communities through the purchase and placement of Naloxone and emergency devices used to rapidly reverse the effects of opioid overdoses. The training of licensed healthcare providers and emergency responders on the use of the device will also be conducted through this program." Norris adds there is one element of prescription drug abuse many citizens fail to recognize - it can happen to anyone.

"Prescription drug abuse and overdose is a problem that does not know ethnicity or social economic background. We as citizens could help prevent prescription drug abuse by keeping the prescriptions secured and destroying our unused medications," he urges.

"I believe that HB 1948 will also help doctors identify prescription drug seekers who abuse prescription drugs and those who 'doctor shop' to obtain prescription drugs for illegal distribution. I also hope that this new law is enforced and if it is found that doctors are prescribing the listed controlled drugs to prescription drug seekers that there will be repercussions. It will take all of us to get the numbers of overdose deaths down and if each of us does our part, I believe we can make a difference."

In 2013, Oklahoma had the eighth highest age-adjusted drug overdose death rate in the nation.

 

Common prescription opioids include:

• Codeine (only available in generic form)

• Fentanyl (Actiq, Duragesic, Fentora)

• Hydrocodone (Hysingla ER, Zohydro ER)

• Hydrocodone/acetaminophen (Lorcet, Lortab, Norco, Vicodin)

• Hydromorphone (Dilaudid, Exalgo)

• Meperidine (Demerol)

• Morphine (Astramorph, Avinza, Kadian, MS Contin, Ora-Morph SR)

• Oxycodone (OxyContin, Oxecta, Roxicodone)

• Oxycodone and acetaminophen (Percocet, Endocet, Roxicet)