Understanding Drug Dependence
West Virginia Leads Nation In Prescription Drug Addiction And Abuse
Despite widespread national publicity, and both public and private efforts to improve the situation, nothing is reducing prescription drug overdose mortality on a statewide -- or national -- level, says the National Center for Injury Prevention and Control. And in West Virginia, prescription drug addiction, abuse, and deaths involving opioid painkillers is more than twice the national average.
A study published this week in the Journal of the American Medical Association (JAMA) found that in 2006 in West Virginia, 93 percent of all prescription drug related deaths involved opioid painkillers like methadone, hydrocodone and oxycodone. And methadone was to blame for nearly half of them.
Overall, the study put West Virginia's unintentional prescription drug related fatal overdose rate at roughly 16 deaths per 100,000 residents, more than twice the national average.
Illicitly obtaining pharmaceuticals to support prescription drug addiction and abuse is common everywhere in the country, and West Virginia is near the top of that list. Among those whose deaths were linked to prescribed opioids, 56 percent were never actually prescribed those drugs, the study says, suggesting that the victims purchased or otherwise obtained redirected prescribed narcotics. Another 20 percent of all fatal overdoses in the state showed signs of illegal "doctor shopping'' -- defined in the state as visits to five or more doctors and faking symptoms to get a prescription.
As well as illegally obtaining others’ prescriptions and doctor shopping, prescription drug addiction is widely supported by “black market” Internet pharmacies that don’t require real prescriptions, by thefts and armed robberies from drug stores, and by purchasing stolen drugs on the street.
The federal Drug Enforcement Agency reports phenomenal growth in the legal distribution of opioid painkillers in the last decade, especially in the Appalachian region. In 2006, four of the five states where hydrocodone had the highest per capita distribution were in Appalachia -- Tennessee, Kentucky, West Virginia and Alabama.
Prescription drug addiction involving opioid painkillers is an “absolute epidemic” according to Dr. Carl Sullivan, medical director of addiction programs at West Virginia University. And a shortage of treatment facilities is an enormous problem.
“Lack of treatment resources -- beds at in-patient facilities, training for doctors and access for patients in rural areas is so pathetically inadequate it's embarrassing. If you have diabetes, you can get treatment. If you have high blood pressure, you can get treatment. If you have opioid addiction, you're out there on your own,” he said.
Questions about methadone remain unanswered in the JAMA study. With 40 percent of all fatal overdoses, it seems obvious that methadone must be more prevalent than the other painkillers, the article states. But the opposite is actually true -- methadone accounted for less distribution in the state than the other drugs.
DEA figures show methadone was distributed in West Virginia in 2006 at a rate of 2,374 grams per 100,000 people -- actually less than the national average. Oxycodone, meanwhile, was distributed at a rate of 17,384 grams per 100,000 people, and hydrocodone at 20,389 grams per 100,000 people -- 10 times more than methadone.
“This suggests either that methadone is for unknown reasons favored by drug diverters, or that methadone is more risky to users than other opioids,” the report concluded.
Such an inane and vague conclusion from the prestigious Journal fairly boggles the mind. It’s been known for decades that methadone carries far greater risks of overdose than all the other common opioid painkillers. In fact it has been suggested several times by medical associations and drug experts that most physicians need additional training in methadone because of its inherent dangers, for both fatal overdose and dependence leading to prescription drug addiction.
In West Virginia, and everywhere else that opioid painkillers have trapped people in prescription drug addiction, the only best answer is a medical drug detox program to overcome safely the effects of opioid withdrawal, followed if needed by a thorough, long-term drug rehab.
Rod MacTaggart is a freelance writer that contributes articles on health.