Painkiller abuse becoming a problem

Published 6:44 pm Tuesday, May 25, 2010

Community Editor

Prescription drug abuse is on the rise throughout the county, state and country, according to medical experts.
The No. 1 culprit in Beaufort County: opioid painkillers, said Dr. Thomas M. Penders, acting chief of staff at Beaufort County Medical Center.
Penders said a number of factors have attributed to the rise in painkiller abuse in Beaufort County, and throughout the nation, including the aging population, the Great Recession and online pharmacies.
With the aging of the “baby-boomer” generation has come an increase in the number of pain clinics, and people being prescribed opiates for chronic pain.
Penders said that some people with painkiller prescriptions are selling some, or all, of their medication to others.
“A certain portion are spreading them around to other people,” he said.
This can be attributed, in part, to the onset of the Great Recession, according to Dr. Whitney Dennison, psychiatrist at BCMC’s Ray G. Silverthorne Crisis Center.
The Great Recession saw unemployment skyrocket across the country. Some of the newly jobless found prescription drug dealing as an alternative means to make money.
Dennison said her patients have told her the current street value of OxyContin has reached $1 per milligram, meaning that an 80 milligram dosage is selling for $80.
“The amount of money you can make off meds is ridiculous,” she said.
Many people prescribed painkillers have chosen to sell their pills instead of taking them, according to Wells Armstrong, pharmacy manager at Tayloe’s Hospital Pharmacy in Washington.
“One of the problems is you get a lot of customers that are getting prescription drugs legally, but don’t end up using them,” he said.
Armstrong said physicians are taking drastic measures to make sure their patients are taking their medicine, including drug testing them.
Physicians and pharmacists have found a useful monitoring tool in the state’s Controlled Substances Reporting System.
According to the state’s Department of Health and Human Services’ Web site, the reporting system was established by North Carolina law to improve the state’s ability to identify people who abuse and misuse prescription drugs classified as Schedule II-V controlled substances.
Tayloe’s sends information about every controlled substance it sells to the reporting system at least once a week, Armstrong said. The pharmacy, in turn, can pull up information on anyone filling out a prescription, including his or her name, date of birth, and what he or she has purchased in a certain time frame.
“It has been a help in stopping some of this abuse,” Armstrong said.
Information submitted through the reporting system is privileged, confidential and not considered a public record. Information may only be released under certain circumstances and to people authorized to receive the information, according to the Department of Health and Human Services’ Web site.
The federal government is having a harder time regulating online pharmacies, many of which are operated outside of the U.S.
According to a written statement by Joseph T. Rannazzisi, deputy assistant administrator of the Drug Enforcement Administration’s Office of Diversion Control, the Internet has become one of the fastest methods used today to divert huge quantities of controlled pharmaceuticals.
“These rogue Internet sites are not there to benefit the public, but to generate millions in illegal sales,” he said in the statement.
Penders called online pharmacies “outrageous,” adding that the federal government seems to be cracking down on them.
Penders, as well as Dennison, said part of the problem is that people think prescription drugs, including painkillers, aren’t as bad as illicit drugs because they’re legal.
“We do have a misconception that they’re not bad,” Dennison said. “In some ways, they’re worse.”
Opioid painkillers now cause more drug overdose deaths than cocaine and heroin, combined, according to the DEA’s Web site.
“Nearly one in 10 high school seniors admits to abusing powerful prescription painkillers. About 40 percent of teens, and an almost equal number of parents, think abusing prescription painkillers is safer than abusing ‘street’ drugs,” reads the Web site.
Not only are painkillers deadly, but they’re also extremely addictive and very resistant to treatment, Penders said.
About 93 percent of painkiller abusers that check into rehab relapse within a month, he said.
“There’s no effective treatment,” Penders said. “It takes a tremendous amount of continuous support, like AA, or opiate maintenance, like methadone.”
He said painkiller abusers interested in getting clean need to stabilize their lives and lower their expectations before checking into a rehabilitation center, like BCMC’s crisis center.
“When people make a commitment, it takes more than a weekend at Silverthorne,” he said, adding that he recommends going “cold turkey.”
Penders said opiate withdrawal is not physically dangerous in young, healthy people.
“There’s a much bigger commitment to the psychological part,” he said.
Dennison said the doctors at BCMC’s crisis center, herself included, are there to help individuals get started on their journey toward sobriety.
“We hook them up with the resources they need,” she said.
According to Penders, it’s hard to reach a balance between giving patients the help they need and overprescribing them. As he said, it’s still a work in progress.