http://online.wsj.com/article/SB10001424127887324281004578352243321552104.html?mod=googlenews_wsj
By TIMOTHY W. MARTIN
The epidemic in painkiller-abuse gripping the Southern and Eastern U.S. is tightening its hold on the Western part of the country, having blindsided law enforcement and public health authorities.
Timothy Martin has details of the epidemic in painkiller abuse that has gripped the Southern and Eastern U.S. and that is now taking hold of Western states as well. Photo: AP Images.
"We're just in the beginning stages of grasping the full magnitude of this issue," said Elisha Figueroa, Idaho's drug-policy administrator, who started noticing that prescription-drug abuse was becoming pervasive in her state about two years ago.
The painkiller issue is so new to the region that states are still diagnosing the problem and developing policies and regulations to combat it. The problem arrived after Western states fought a long battle against rampant methamphetamine abuse.
In the absence of a unified, federal approach, there has been uneven success nationwide combating painkillers. The Obama Administration has said individual states should be able to address the problem faster, though some states have sought more federal involvement.
More than 16,000 people die from opioid overdoses every year. Now, Dr. Russell Portenoy, who campaigned for wider prescription of pain medications like Vicodin, Oxycontin and Percocet, is having second thoughts. WSJ's Thomas Catan reports. Photo: Bryan Thomas.
Now, Oregon, Colorado, Washington and Idaho have the nation's highest rates of prescription-drug abuse, according to a 2010-11 annual survey, the latest from the Substance Abuse and Mental Health Services Administration, released in January.
According to the latest SAMHSA survey, 6.5% of Oregon residents aged 12 years and older abuse opioid painkillers, compared with 4.5% of residents in Kentucky, once one of the leading states for abuse. Oregon sat atop the most-recent survey.
Areas once considered epicenters of the epidemic still have substantial rates of abuse, and populous states like Florida and New York have larger absolute numbers of people who abuse painkilling drugs.
But abuse rates are down in the South and Appalachia, where painkiller use was so rampant a decade ago that highly addictive oxycodone pills were nicknamed "Hillbilly Heroin." Southern and Appalachian states dominated the SAMHSA survey in 2007.
Multiyear public outreach programs on safe disposal of painkillers have cut the number of pills swiped from medicine cabinets. And a raft of state laws have hindered the black-market supply.
Kentucky launched a state task force to crack down on overprescribing physicians in 2009 and took steps to educate the public on the proper disposal of unused painkillers. Such efforts helped push its ranking to No. 31 in the SAMHSA report, from No. 6 two years earlier.
Hospitals in Florida and elsewhere are grappling with the latest fallout from the epidemic of prescription-drug abuse: babies born addicted to painkillers. The newborns present new challenges for hospitals. Photo: Jason Henry/The Wall Street Journal
And West Virginia fell out of the top 10 in recent years by organizing more than 100 community forums across the state to raise awareness of the painkiller problem and by helping craft localized countermeasures. In 2010, lawmakers stiffened penalties for falsifying information to score prescriptions, among other measures. The state's abuse rate is at 4.8%, or 21st in the nation, compared with 5.9% two years earlier.
In Florida, regional drug strike forces were created by Gov. Rick Scott in March 2011, helping throttle black-market supply. New legislation limited pain-clinic ownership to health-care professionals. Abuse rates fell in a year from 4.4% to 4%, according to SAMHSA, though bigger gains could be seen in future reports as the government data catches up with the situation on the ground.
Drug-trafficking rings have sprouted in Washington, Colorado and other sparsely populated Western states since 2009, according to law enforcement.
Addicts and dealers obtain large quantities of oxycodone or hydrocodone from doctors in Nevada and Southern California, where lax rules have led to pill mills. From there, they transport the drugs to other states.
Arizona is ranked sixth in the SAMHSA survey and doesn't have a unified strategy to battle prescription-drug abuse. Gov. Jan Brewer's office and the state's criminal justice commission launched pilot programs to improve physician education in safely prescribing painkillers in three counties last year, said Merilee Fowler, who leads a pilot program in Yavapai County. "With prescription-drug abuse, it just kept creeping up and creeping up," she said.
Colorado hospital admissions due to opioids grew to 7% of all visits in 2012, nearly triple 2004's 2.5%, according to state data. Yet the state's drug task force is still dedicated solely to tackling methamphetamine issues. Legislators this year will explore freeing up resources to deal with painkiller abuse, said John W. Suthers, Colorado's attorney general.
In Oregon, a program to track painkiller prescriptions was launched 18 months ago. "We didn't start seeing painkillers as an issue until we saw a spike in overdose deaths" around 2008, said Tom Burns, director of pharmacy programs at the Oregon Health Authority. Overdose deaths from painkillers rose 172%, from 218 in 2004 to 378 in 2011, according to Oregon data.
Washington state unveiled pain-management guidelines for health-care providers two years ago to curb overprescribing of powerful opioids. Painkiller overdose deaths peaked at 512 in 2008,
but they dropped 23% to 407 in 2011, latest state data show.
Write to Timothy W. Martin at
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