September 16, 2011

No Easy Fix for Prescription Drug Abuse

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OKLAHOMA CITY – There’s no simple solution to Oklahoma’s extensive prescription drug abuse problem, state lawmakers were told Wednesday.

Oklahoma leads the nation in nonmedical use of pain relievers in the past year among all age categories, representatives for the Department of Mental Health and Substance Abuse Services told the panel.

Rep. Richard Morrissette, D-Oklahoma City, led Wednesday’s interim study to examine possible legislative solutions to Oklahoma’s prescription drug problem.

Even with a state prescription monitoring program in place since 2006, lawmakers learned of one woman who was able to legally obtain 3,488 pills in 10 months through visits to more than 20 physicians.

That woman lived, but deaths due to unintentional prescription drug overdoses in Oklahoma have increased by at least 105 percent over the past decade, according to the Oklahoma Bureau of Narcotics and Dangerous Drugs.

Darrell Weaver, director of the OBNDD, said about 65 percent of physicians use the state’s database before writing prescriptions for patients.

Physician participation is not mandatory in Oklahoma; only pharmacists are required to enter information each time they dispense drugs in the state.

“We believe there’s over 100,000 Oklahomans addicted to prescription drugs,” Weaver said. “We’re not going to arrest our way out of this problem.”

Requiring Oklahoma physicians to use the database might help stop abuse and overdoses on prescription drugs, said Weaver and several doctors who spoke Wednesday.

Dr. Andrew Revelis of Tulsa Pain Consultants said his office requires mandatory drug testing, checking the state database and criminal background checks before issuing prescriptions for opioid pain medications such as hydrocodone. They’re useful tools to prevent abuse that physicians can use without financial strain, he argued.

But Liz Langthorn of the Oklahoma State Department of Health said many health-care providers will push back against further legislative requirements for prescribing medications.

Some providers have told health department officials they work under hospital policies preventing them from using the Internet in their workplace, even to check the prescription monitoring database, Langthorn said.

Michael Cooper, a physician from Claremore, told legislators that in a health-care system where doctors only have a few minutes to spend with each patient, adding mandatory time spent checking databases and conducting urine tests is unrealistic.

The ghost in the room Wednesday was former University of Oklahoma football player Austin Box, whose death in May is attributed to “mixed drug toxicity” from prescription pain pills and anti-anxiety medication.

Morrissette questioned several times how Box, in an elite college football program surrounded by team physicians and trainers, was able to use so many prescription drugs without anyone knowing.

“With somebody, somewhere, the red flag should have gone up,” he said.

Police have determined that Box, who endured several serious injuries and surgeries in his football career, did not have any valid prescriptions on file for the drugs found in his system. In July, the state medical examiner issued a preliminary report that Box died from a combination of oxymorphone, morphine, hydrocodone, hydromorphone, oxycodone and alprazolam.

Recovering addict Lea Gray of Hollis spoke of how addiction to prescription drugs nearly killed her and ruined her life. She was first prescribed the drugs at age 15 for a congenital bone deformity, but she was an addict into her late 20s.

“It turns you into the monster you never thought you’d become,” she said.

Physicians prescribed her the pills for almost nine years before realizing she was an addict who was abusing painkillers in addition to illicit drugs, she said.

Dr. Hal Vorse, a physician who specializes in treatment of chemical dependency, said lack of education among physicians is part of the problem.

In Oklahoma, a person can attend medical school, complete internships and residency, and begin practicing medicine without any training in chemical dependency or addiction treatment, he said.

“I don’t believe the average physician understands the gravity of the situation,” he said. “How many more Austin Boxes do we need?”

Box’s death has put a spotlight on the issue, Morrissette said.

But whether lawmakers can garner support for changing laws governing how opioid painkillers are prescribed and distributed remains to be seen, he said.