The Edmond Sun

Local News

February 10, 2014

Pill problems

Prescription drug overdoses continue to climb in state

OKLA. CITY — Oklahoma pharmacies filled nearly 10 million prescriptions for narcotic painkillers and other controlled dangerous substances last year, according to newly obtained state data.

Those prescriptions — an average of 68 per patient, including refills — contained 597 million doses of painkillers, tranquilizers, sleeping pills, steroids and other controlled pharmaceuticals tracked by the state’s Prescription Monitoring Program.

Nearly 16,000 medical professionals are registered to write narcotics prescriptions in Oklahoma. About 1,500 of them accounted for nearly three-fourths of all controlled substance prescriptions filled in 2013, officials said.

The statistics, provided to Oklahoma Watch in response to an open records request, also show that many medical professionals do not routinely check the PMP’s online database before writing or refilling scripts. Under current law, they are not required to do so.

“The more we drill down, the more we realize that we obviously have a prescription drug problem in Oklahoma,” said Darrell Weaver, director of the Oklahoma Bureau of Narcotics and Dangerous Drugs.

“We’ve got to be aggressive in doing something to drive these numbers down.”

Meanwhile, the toll from prescription drug abuse continues to rise. In 2012, the most recent year for which data is available, 844 Oklahomans were killed by overdoses, most of them accidental. That’s more than the 708 people killed in vehicle crashes that year.

Three out of four overdose deaths involved prescription drugs, often in combination.

The prescribing data, compiled by Weaver’s bureau, provides new insight into one of the causes of Oklahoma’s escalating prescription drug crisis.

It also provides ammunition to Gov. Mary Fallin and others who want the Legislature to take new steps this year to require more physician participation in the PMP.

“I think it’s more likely than not that we will endorse an approach that will have an element of mandatory checks of the Prescription Monitoring Program,” said Steve Mullins, Fallin’s general counsel.

“It’s a pretty high priority for the governor,” Mullins said. “She’s seen the data. It’s affecting way too many Oklahomans. It really is tearing up families.”

Leading the list of PMP prescriptions and overdose contributors are three popular pharmaceuticals: hydrocodone, an opiod painkiller sold under the brand names Lortab, Vicodin, Vicoprofen, Norco and Tussionex; oxycodone, another opiod painkiller sold as OxyContin and Percoset, and alprazolam, an anti-anxiety drug marketed as Xanax.

Although the overdose rate from alprazolam is generally not high when used by itself, physicians say it can become lethal when combined with narcotic painkillers. Many overdose deaths involve a “cocktail” of more than one controlled substance, and sometimes alcohol.

The prescriptions filled in 2013 were issued to 142,369 patients. That’s an average of 68 prescriptions per patient. Since many controlled substances require a new prescription with every refill, a patient with chronic problems would typically log 12 prescriptions per year for each controlled substance he or she receives.

Last year’s PMP prescriptions were written by 12,096 doctors, osteopaths, dentists, physician assistants, nurse practitioners and other medical professionals. Of those, 3,529 registered prescribers ran PMP checks during the year.

Some of the prescribers were located out of state and can’t access Oklahoma’s PMP system before writing prescriptions, bureau officials said. Some were Oklahoma practitioners who write only a handful of controlled substance prescriptions per year and aren’t necessarily expected to check the PMP regularly.

Officials say the usage statistics understate prescriber participation in the PMP system, which is designed to deter “doctor shopping” by allowing doctors to see every narcotic prescription filled by a patient during the previous 12 months.

In some clinics, for example, one staff person might be running PMP checks for several doctors but entering only one registration number for each check. Also, one PMP check might apply to several prescriptions being written at the same time by a single doctor.

Bureau officials said about 74 percent of Oklahoma prescribers who wrote more than 10 controlled substance prescriptions logged into the PMP system at some point last year.

Fallin’s office is working with lawmakers, law enforcement authorities, health officials and medical practitioners to devise a collaborative strategy acceptable to all sides. It is likely to include new restrictions on prescribing practices, tougher penalties for offenders and more public and professional outreach campaigns.

“We’re all in this together,” Weaver said. “We’re not going to arrest our way out of this problem. We’ve got to have our physicians involved. They’ve got to police themselves.”

The latest overdose data show that Oklahomans are being killed by prescription drugs at a rate of nearly two people per day.

The drug overdose fatality count climbed 80 percent over the past decade. Deaths caused by hydrocodone and oxycodone more than quadrupled over the 10-year period.

Weaver said he’s perplexed that the toll has continued to rise despite concerted efforts to call more attention to the problem., which claimed the life of University of Oklahoma linebacker Austin Box and sidelined the career of Oklahoma State University basketball coach Sean Sutton.

“This is something that’s affecting normal Oklahomans,” Weaver said. “School teachers. Police officers. People who are out there functioning in their day-to-day business.”

At least Oklahoma no longer ranks No. 1 in prescription painkiller abuse, as it did several years ago. The latest survey by the federal Substance Abuse and Mental Health Services Administration shows that the Sooner state has fallen to No. 8 on the Rx drug-abuse list.

According to the 2012 survey, 5.2 percent of Oklahomans above the age of 11 took prescription pain medicines for nonmedical reasons during the previous 12 months. The biggest pill poppers were 18- to-25 year-olds, who had an abuse rate of 10.9 percent.

State officials and addiction specialists say they have been particularly alarmed by recent data suggesting that some people who become addicted to prescription painkillers eventually switch to street heroin.

“We’re learning that it’s become a gateway drug to heroin,” Mullins said.

The danger of rising heroin use made headlines last week when actor Philip Seymour Hoffman died of an apparent overdose. Authorities said they found heroin and prescription drugs at his residence. Hoffman told an interviewer he had resumed a history of drug abuse last year by taking prescription painkillers, then progressing to heroin.

Hal Vorse, a physician who treats habitual drug users and teaches new doctors about addiction at the University of Oklahoma Health Sciences Center, said he’s seen the phenomenon in his own practice.

“We’re seeing a big surge in heroin, and 85 percent of those people started on prescription opiates,” Vorse said. “The cost of their addiction got so high that they switched to heroin because it’s cheaper.”

Vorse said the price on the street for OxyContin has risen to $1 to $1.50 per milligram. Addicts typically use 200 to 300 milligrams per day, he said. “They find out they can get an equivalent dose of heroin for a third of what it costs for Oxys,” Vorse said.

“It’s just like Prohibition in the ’20s. People who couldn’t get good whiskey bought moonshine. The problem with heroin is there’s no quality control. You don’t know what you’re getting.”

Getting more doctors to participate in the Prescription Monitoring Program is a central element of the state’s prescription drug-abuse offensive.

The PMP is an online database designed to flag patients who seek multiple prescriptions for painkillers and other narcotic drugs from more than one physician.

Oklahoma’s system is considered one of the most advanced in the nation, officials say. All pharmacists are required to enter data for every controlled drug prescription within 5 minutes of filling it. No other state has a “real-time” reporting requirement like that.

But doctors and other health practitioners are not required to check the database before prescribing controlled dangerous substances, and some don’t bother to do so. The only exception is methadone.

Although pharmacists are required to log controlled substance prescriptions into the system, current law does not require them to review a patient’s prescribing history before filling the order. Bureau officials said checking a patient’s history requires a different computer log-in process than entering prescription data.

If they do review a patient’s history and see evidence of multiple concurrent prescriptions, pharmacists have the authority to refuse to fill a prescription, alert the prescribing physician or contact state authorities, bureau officials said.

Oklahoma’s doctors have resisted proposals to require them to use the system each time they write a prescription for a controlled substance.

Two years ago, the Oklahoma State Medical Association sent a letter to lawmakers saying that mandatory PMP checks for every narcotics prescription “will require additional staff time and resources in physicians’ offices and result in higher costs and longer waits for patients.” It urged them to reject the proposal.

But the medical group says it is willing to consider a less comprehensive mandate, one that requires occasional checks and lets office staffers handle the job instead of the requiring doctors to do it.  

“We are meeting with the governor’s staff and all of the stakeholders involved with that,” said Ken King, executive director of the medical association. “We want to make sure that any solution is a true solution, and not something that tries to make the physician the policeman in this process.”

State Medical Association President Robert McCaffree, a pulmonary disease physician, said Oklahoma doctors continue to hear a mixed message about the use of prescription painkillers.

“We’re often told as physicians that pain is undertreated,” McCaffree said.

“But we also have this issue that there are prescription drug abuses. The physicians are caught in the middle. How do we best be the advocates for our patients but also be responsible to society?”

State officials said they will look at several options for new legislation to increase physician use of the PMP.

OKLAHOMA WATCH is a nonprofit, nonpartisan journalism service that produces in-depth and investigative content on important public-policy issues facing the state. For other content, go to www.oklahomawatch.org.

1
Text Only
Local News
  • Boston 1 Arcadia man, 80, prepares for 111th marathon

    A year ago, Arcadia resident Tom Briggs was well into the Boston Marathon course when he heard runners nearby talking about an incident up ahead.

    April 19, 2014 3 Photos

  • Anne Josette Hill Police seek teen last seen in Edmond-north OKC area

    The family of a missing teenage girl made a plea to the public Friday to help them find the Casady honors student.

    April 19, 2014 2 Photos

  • 4-19 Calendar

    For information about Edmond senior programs, stop by and pick up a monthly calendar, check out the website at edmondseniorcenter.com or call 216-7600. Lunch is served at 11:30 a.m. and reservations are needed a day in advance by 11 a.m. For lunch reservations, call 330-6293 from 9 a.m. to 1 p.m.

    April 19, 2014

  • UCO plans Earth Day Fair

    The University of Central Oklahoma invites the community to celebrate sustainability with its Earth Day Fair from 10 a.m. to 6 p.m. April 22 in locations throughout Central’s campus.
    The fair kicks off at 10 a.m. around Broncho Lake with exhibitions from local businesses, state agencies and student organizations. Visitors will have the opportunity to learn about its environmental mission and message.

    April 19, 2014

  • UCO School of Music closes semester with concert series

    The University of Central Oklahoma School of Music will wrap up its instrumental performance season with three concerts featuring Central students April 29 through May 1 at Mitchell Hall Theater located on the UCO campus.    

    April 19, 2014

  • Fine Arts 1 Auction benefits Fine Arts Institute

    The Spring Sampler dinner and auction event April 12 at Oak Tree Country Club benefitted the Fine Arts Institute of Edmond.

    April 18, 2014 4 Photos

  • Kaiser joins Thunder ownership group

    Tulsa businessman George B. Kaiser has been approved by the NBA Board of Governors as a new partner in The Professional Basketball Club LLC, which owns the Oklahoma City Thunder. Thunder Chairman and CEO Clayton I. Bennett made the announcement Friday. Kaiser is purchasing the ownership interest of Tom L. Ward.
    “We are honored to welcome George Kaiser as a member of the ownership group of the Oklahoma City Thunder,” Bennett said. “George is a well-respected and important Oklahoma business leader, as well as one of the state and nation’s top philanthropists. His commitment to successful business and community leadership is in true alignment with that of the Thunder.
    “I also appreciate the commitment and leadership provided by Tom Ward as a member of our ownership group from the beginning,” Bennett added.

    April 18, 2014

  • Literally, books come to life for club

    When some of the women at Touchmark at Coffee Creek got together to form a book club, they didn’t know it would be so much fun and become such an important part of their lives.
    The group of about a dozen residents gets together monthly to not only discuss the assigned novel, memoir or classic, but also to immerse themselves in the setting and culture of the book. There is no limit to their creativity.

    April 18, 2014

  • pink.jpg Local children win Edmond Sun Easter coloring contest

    Two local children were named winners of The Edmond Sun’s Easter coloring contest. At left, Madsion Porter, 4, daughter of Tracy Porter, won a princess Easter basket, which included a tiara, tea set, stuffed bunny rabbit and chocolate rabbit. At right, BriAnna Harbaugh, 9, daughter of Leslie Haubaugh, won a Hello Kitty Easter basket, containing art supplies, a Hello Kitty stuffed animal and a chocolate bunny.  The families also received a three-month subscription to The Edmond Sun. For your own subscription to The Edmond Sun, visit edmondsun.com, call 341-2121, or visit 123 S. Broadway.

    April 18, 2014 2 Photos

  • jc_HarveySparks.jpg Pastor seeks congressional seat

    Working in the Congressional 1st District office of Congressman Jim Bridenstine was an eye opener for Harvey Sparks, he said. His analytical exposure to Congress has sparked his drive to run for the Congressional 5th District of Oklahoma, said Sparks, R-Oklahoma City.
    Sparks has been a pastor for the majority of his professional life. Sixteen months ago, he was asked by 1st District Congressman Jim Bridenstine to come work in his Washington, D.C., office. He and his wife, Jennifer, have three daughters and a son, ages 10-3.

    April 18, 2014 1 Photo

Featured Ads
NDN Video
Jabari Parker's Top 5 Plays From Duke Career Kourtney Kardashian Is a Bikini Babe More Manpower Than Ever Expected At 4/20 Rally Debunk'd: Miley Cyrus AIDS, Cheeseburgers Cause Cancer, Military Warning Bill Previewing the NBA playoffs Raw: Orthodox Christians Observe Easter Rite My name is Cocaine Raw: Space X Launches to Space Station Lohan Gets Candid About Her Sex List The 2014 New York Auto Show Meet Johnny Manziel's New Girlfriend Chelsea Clinton Announces Pregnancy Funny: Celebrating Easter with Martha Stewart and Friends Man Accuses 'X-Men' Director Bryan Singer of Sexually Abusing Him As a Teenager Man hit with $525 federal fine after he doesn't pay for soda refill Lea Michele & Naya Rivera Feuding? Jabari Parker declares for the NBA draft Singing Nun Belts Out Cyndi Lauper New West, Texas Explosion Video Swim Daily, Throwback Thursday
Poll

Do you agree with a state budget proposal that takes some funds away from road and bridge projects to ramp up education funding by $29.85 million per year until schools are receiving $600 million more a year than they are now? In years in which 1 percent revenue growth does not occur in the general fund, the transfer would not take place.

Agree
Disagree
Undecided
     View Results