The National Institute on Drug Abuse estimates that 20 percent of United States citizens have used prescription drugs for nonmedical reasons. While drugs prescribed as sedatives or tranquilizers, such as Xanax or Valium, and stimulants, such as Adderall or Ritalin, are of great concern, the misuse of opioids has become an epidemic in parts of Ohio, including Southeast Ohio. Opioids, also called opiates, are prescribed for pain relief and include such drugs as Vicodin, Percocet, Methadone, Darvocet, Lortab and Oxycontin. Unfortunately, these medicines can easily and unknowingly create a physical dependency.
According to the Ohio Department of Health, Office of Vital Statistics, in 2007 unintentional drug overdoses became the leading cause of injury death in Ohio, surpassing motor vehicle accidents and suicide for the first time on record. From 1999 to 2009, the state's death rate from unintentional drug poisonings increased 335 percent, largely driven by pain medication overdoses; prescription opiates were involved in about 40 percent of 2009 fatal drug overdoses in Ohio, more than heroin and cocaine combined (36 percent). The Ohio Substance Abuse Monitoring (OSAM) Network reports that first time users are as young as 11 or 12 years of age and are most likely to obtain prescription opioids from medicine cabinets in their homes or in the homes of friends and relatives.
Some short term effects of opioid use are sedation and drowsiness, constipation, impaired thinking and coordination, memory loss and depressed respiration. Long term effects can include physical dependency, liver damage and severe respiratory depression that can lead to death. If you suspect a loved one is developing an opioid dependency, look for the warning signs: The individual's tolerance may be building to the point that he or she will increase usage of the drug to achieve the desired effects. He or she may continue to complain of pain long after the medical issue has been resolved and may devote an inordinate amount of time and effort, including driving long distances and "doctor shopping," to obtain more of the medication. Normal habits of hygiene, eating and sleeping patterns, and personality may change. The person may neglect everyday responsibilities as the addiction takes greater priority. Social withdrawal, forgetfulness and even blackouts can accompany opioid misuse and dependency. The addicted individual will often go to great lengths to hide the addiction and become extremely defensive or angry if he or she suspects the secret has been discovered.
Why is this such a problem and what is being done about it? The document "Epidemic of Prescription Drug Abuse in Ohio," published on the website dontgetmestartedohio.org, lists contributing factors to the surge of opioid dependency:
Increased marketing by pharmaceutical companies to primary care providers and even directly to consumers.
The release of new opioids into the market.
New extended release opioids (e.g., Oxycontin) marketed aggressively to prescribers.
New uses for drugs (e.g., methadone being used as a pain medication).
Numerous organizations providing new chronic pain management guidelines promoting the use of opioids.
The perceived patients' right to pain relief.
The perceived legitimacy and safety of prescription drugs.
Increasing and widespread prescription drug diversion.
Increased access to internet and the growth on online "pharmacies."
"Pill Mills" (unscrupulous providers of pain medication in exchange for cash).
The high street value of prescription drugs.
The deception of providers that allows for doctor shopping and prescription fraud.
Growing prescription opioid abuse and addiction after exposure to the medications, in many cases for legitimate medical purposes.
Many legitimate pain clinics have helped Ohioans return to productive lives, but as Cheri Walter, CEO of the Ohio Association of County Behavioral Health Authorities (OACBHA), states, "a few bad actors have been calling themselves pain clinics only as a way to both prescribe and distribute drugs at one-stop pill mills." Today provisions in House Bill 93 give state regulators more tools to crack down on the abusers. In addition, Ohio's Automated Rx Reporting System (OARRS) allows pharmacists and prescribers to decrease the opportunity for abuse. Unused prescriptions can become misappropriated and abused; Drug Take-Back programs now provide for proper disposal of unused medications - over nine tons of medications were turned in for disposal during Ohio's October 2011 Drug Take-Back Day. Led by local ADAMH (Alcohol, Drug Addiction and Mental Health) Boards, several Ohio communities have created opiate task forces. OACBHA and ODADAS (Ohio Department of Alcohol and Drug Addiction Services) have recently joined forces to launch "Don't Get Me Started," a statewide public service campaign designed to educate young adults about prescription opiate abuse and addiction.
Much has been done, but more is needed to address this growing problem in our communities.
Miriam Keith is consumer support coordinator of the Washington County Mental Health and Addiction Recovery Board. Mental Health Matters appears on the Opinion page on the first Saturday of each month.