America’s opioid epidemic is everywhere — but it’s especially bad in these 5 states

Posted on: February 25th, 2016

Published: Feb 24, 2016 2:29 p.m. ET By EMMA COURT – REPORTER

When it comes to the prescription-painkiller problem in America, statistics speak louder than words: The U.S. consumes more opioids—from certain prescription pain relievers to heroin—than any other country.

While no state is exempt from the addiction and overdose epidemic, it’s particularly acute among younger people and in certain states. West Virginia, New Mexico, Kentucky, Nevada and Oklahoma have the highest drug overdose death rates, and many of those states are also home to the highest painkiller prescription rates.

The crisis is so severe that drugstore chains are increasingly selling naloxone, a drug to reverse opioid overdoses, without a prescription.
“It’s an epidemic everywhere, in all 50 states,” said Rich Hamburg, acting CEO of Trust for America’s Health, a nonprofit group that advocates for disease prevention efforts. “The numbers are pretty amazing.”

Deaths by drug overdose soared 605% between 1999 and 2010 in West Virginia, which had the highest such rate, according to a Trust for America’s Health report. The rate quadrupled in Kentucky and tripled in Oklahoma, while it increased 80% in Nevada and 59% in New Mexico.

These states could have higher levels of chronic disease and pain, explaining high prescription rates that then lead to addiction, Hamburg said. Opioid use is also more prevalent among those with less education and less money, and these states tend to be among the poorest in America.

But while rates vary by state, addiction to prescription painkillers—Vicodin, OxyContin, Opana and Methadone—isn’t just an issue for one group. Urban areas, such as New York City, also are seeing rates of opioid abuse soar, and increased abuse among white, wealthier groups has given it a higher political profile.

Many who get hooked on the painkillers move on to heroin, which is cheaper.

The painkiller problem goes back to the late 1990s, when Purdue Pharma LP’s OxyContin went on sale and untreated pain began to be seen as a significant problem—with a solution that could be prescribed. Some experts also say the marketing of these drugs contributed to increased prescription rates.

Finding a solution to the crisis is complicated by the fact that people gain access to opioids in many different ways. Some find pills in their parents’ medicine cabinets. Others “doctor shop” and get multiple prescriptions at multiple pharmacies. One solution floated at a Senate committee hearing Tuesday is to crack down on seniors on Medicare who do just that. (Such anti-doctor-shopping programs are already used for Medicaid plans.)

Reducing the overprescription of painkillers

In the last 15 years, prescription painkillers have been given out far more frequently and also in larger quantities than needed, experts say. Getting a wisdom tooth pulled? You may get a prescription for 30 or 40 pills, Hamburg said. Yet patients rarely use them.

One strategy is to reduce the number of painkiller prescriptions being written. The Centers for Disease Control and Prevention is currently drafting prescription guidelines for chronic pain.

Such guidelines must balance the opioid crisis against legitimate needs for such drugs, said Dr. Richard Rosenthal, head of Addiction Psychiatry for the Mount Sinai Behavioral Health System.

“Pain is something that should be treated,” Rosenthal said. “But when you treat pain, these are potentially dangerous medications… It’s not just like having an Aspirin in the cabinet.”

Improving prescription monitoring

Prescription-monitoring programs prevent a person from getting the drugs prescribed by more than one doctor and filled at different pharmacies. They have proven to be quite effective, but although they exist in 49 states, the quality of those programs varies, Hamburg said.

Good monitoring programs can track so-called pill mills, or underregulated pain clinics, that are hubs of overprescribing.

A variant is a “lock-in” program, which identifies patients who abuse these medications and then confines them to using only one doctor and pharmacy, to prevent “doctor shopping” practices.

• Helping prevent overdose deaths

To open up access to lifesaving “rescue drugs,” Walgreens Boots Alliance Inc.WBA, -0.53%  said Monday that it has made one such drug, Naloxone, available over-the-counter in Indiana pharmacies. It’s something CVS Health Corp.CVS, +0.37%  pharmacies currently does in 14 states.

Then there are Good Samaritan statutes being passed or changed in various states to facilitate calls for medical help for an overdose without risking being charged for a low-level drug law violation.

Getting rid of old drugs in medicine cabinets

“Take-back” programs aim to get consumers to dispose of unused medications at safe places such as local police stations.

That’s critical because many teenagers and young adults—12 to 25-year-olds overdosing and dying at high rates—are taking prescriptions pills that have been forgotten in the back of medicine cabinets, Hamburg said.