Encouraging signs opioid overdose rate is on the decline

• Published May 29, 2012

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The misuse of prescription opiate drugs in Thurston County and the state, which began in 1995 and got steadily worse over the next 16 years, is finally being addressed in a serious way by the Legislature and physician regulators.

Like every other region of the state, these super-strength painkillers – such as hydrocodone, methadone and oxycodone, the main agent in OxyContin – are the most prescribed type of medications here. And they are killing people.

From 1995 to 2008, opioid-related deaths in Washington increased from 23 to 505 per year, a rise of more than 2,000 percent. All of these accidental overdoses occurred when the victims mixed a prescription opioid with alcohol or some other prescription or illicit drug.

But that’s not all. According to Jim Cooper, executive director of Together, a substance-abuse and violence prevention nonprofit in Lacey, 3 in 5 teens say they have taken prescription painkillers from their parents’ medicine chests. In addition, youth admissions to treatment programs for opiates is 19 times higher than 10 years ago.

Those alarming trends, enabled by the large pharmaceutical companies, and which the medical profession has done little to resolve, finally got the attention of state lawmakers in 2010, who then passed House Bill 2876. That law directed the state Medical Quality Assurance Commission and the four other boards governing practitioners in nursing, dentistry, osteopathy and podiatry to adopt rules about the management of chronic noncancer pain.

The law went into effect Jan. 2, along with new rules set by the medical commission. It is designed to reverse the overdose death rate trend and, it is hoped, reduce the number of opioids making their way to the street where teenagers and others abuse them for recreational purposes.

Dr. Mimi Pattison, the commission chairwoman, says there are encouraging signs the overdose rate is declining after just the first six months.

The MQAC is aggressively educating the 28,000-plus physicians and physician assistants that it licenses about the new requirement that doctors arrange consultations with pain specialists for patients on high dosages. Powerful painkillers became so popular for treating chronic pain that patients became less aware of alternative treatments, such as physical therapy or acupuncture, and often remained on opioids for extended periods.

The new rules require continuing education in pain management and also provide physicians with guidance on tracking the progress of patients on opioids.

Placing restrictions on physicians and educating them to taper patients off opioids before they become psychologically dependent should ultimately diminish the number of drugs that make their way to the illegal street market.

But the medical community can do only so much. It can’t compensate for parents and other adults who leave their prescriptions unprotected from theft, by their own children or others visiting their households.

Thurston County residents participated in the recent National Take Back the Drugs program, dropping off unused prescriptions at one of five local collection sites. More than 6 tons of drugs statewide were collected in one day.

But in a state where drug overdoses have surpassed car accidents as the leading cause of accidental deaths, there obviously is more work to be done.

As Cooper says, “Prescription drugs are as dangerous, if not more deadly, than street drugs. They need to be secured, just like a loaded weapon.”

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