Officials hope to stem increase in prescription drug overdoses
More Arizonans are dying from overdoses of prescription painkillers such as oxycodone and methadone, a problem the state’s top health official blames in large part on people self-medicating.
“This is a public health issue that’s getting worse, much worse,” said Will Humble, director of the Arizona Department of Health Services.
A report by the Centers for Disease Control and Prevention published earlier this month found that prescription painkillers contributed to 14,800 deaths nationally in 2008, representing about 74 percent of all prescription drug overdose deaths that year.
Prescription painkillers are responsible for more overdose deaths nationally than heroin and cocaine combined, contributing to more than 40 deaths every day, according to the CDC.
In Arizona, the rate of overdose deaths in which prescription painkillers were involved more than doubled from 2004 to 2009, according to state health department data.
“I honestly think that most people don’t understand how dangerous they are and self-medicate and die,” Humble said. “And they leave kids behind.”
Leonard Paulozzi, an epidemiologist for the CDC and the main author of the report, said prescription painkillers can have similar effects to illegal drugs like heroin.
“It has the same ability to kill you in overdose and to cause physical dependence on the medication so that it’s difficult to stop taking it,” he said. “And these are risks that are not adequately appreciated by patients.”
People may use prescription painkillers to treat some types of pain for which those drugs aren’t prescribed, Paulozzi said. People also use them to get high, according to the CDC.
Abuse of those drugs costs health insurers about $72.5 billion each year, according to the report.
The number of deaths from drug overdose involving prescription painkillers more than tripled nationally between 1999 and 2008, according to the CDC.
The report doesn’t break down rates of overdose deaths from prescription painkillers by state because reporting methods vary, Paulozzi said.
A review of Arizona Department of Health Services data on prescription painkiller overdoses showed nearly 8 deaths per 100,000 people in 2009, up from nearly 3 overdose deaths per 100,000 people in 2004.
Yet it is hard to tell how many deaths these drugs cause directly because an overdose may be due to one or several substances.
“This is more a behind-the-scenes kind of situation where … somebody takes a bunch of painkillers before bed and doesn’t wake up,” Humble said. “And the public doesn’t see that.”
Keith Boesen, managing director of the Arizona Poison and Drug Information Center at the University of Arizona, said five people who died in the state since January had used prescription painkillers. The number of deaths might be higher, he said, as not all fatal overdoses get reported to the center.
Boesen said the use of prescription painkillers is expanding in Arizona.
“We’ve seen increases in not just certainly deaths but increases in patients exposed to them, patients asking questions about them,” he said.
In Phoenix, the Banner Good Samaritan Poison and Drug Information Center gets about 20 phone calls a day related to prescription painkillers, said Frank LoVecchio, the center’s co-medical director.
LoVecchio said prescription painkiller users aren’t necessarily drug addicts or outcasts but people misusing those drugs while trying to manage pain.
“In reality, the great majority are pretty functional people,” he said. “And they might have something like back pain and they might go to work but they need this to go through the day.”
The CDC’s Paulozzi said states need to address this issue as they are in charge of regulating the use of prescription drugs.
Humble, director of the state health department, said the government can’t force people to do what is best for them if they don’t want to, but it can inform them about the dangers of prescription painkillers.
“The No. 1 thing is get people to really understand that when they have a prescription for a controlled substance to just take it just as directed, and to keep the extras around and don’t self medicate,” Humble said. “They are controlled substances for a reason.”