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About Street roots. (Portland, OR) 1998-current | View Entire Issue (Oct. 2, 2015)
News Page 7 A nasty habit Oregon practitioners are overprescribing opioids, prompting local and state officials to ramp up efforts to prevent abuse and overdoses BY E M IL Y GREEN administers the life-saving drug, Currently, in order to obtain naloxone in Oregon, a person must get a doctor’s t only took Oregon practitioners six prescription and obtain a training months to write more than 1.4 million certification card, says Marcus Watt, prescriptions for hydrocodone and executive director of Oregon Board of oxycodone, according to Oregon Pharmacy. Prescription Drug Monitoring Program’s . . . . REUTERSZGRETCHEN ERTL “I know there are concerns that access report encompassing the first half of 2015. A nasal injection containing the overdose-reversing drug naloxone is seen at the police isn’t open enough, and there may be some “Oregon and other states have realized headquarters in Quincy, Mass., June 13, 2014. In 2010, Quincy became the first US. city to they’re actually prescribing way more of other future legislative activity to open up make the drug standard equipment fo r its police officers. access even more,” said Watt these drugs than they did 10 years ago,” According to Oregon Health Authority’s says Multnomah County Health Officer Dr. Lisa Millet “We are in conversations with Paul Lewis, adding, “the more that’s OxyContin and a brilliant marketing strategy grew, pharmaceutical companies responded. the Board of Pharmacy about establishing a prescribed, the more overdose deaths there that basically tried to argue that opioids are “What we’ve seen in.recent years is a are.” standing order that would allow anyone to safer than doctors had previously thought - strategy of creating new opioids products to view the training video on the OHA website, He says preliminary analysis shows and more effective - and that it would be market and trying to develop strategies that download and sign the training certificate, opiates were involved in 109 deaths in simply unethical not to prescribe them more either make them safer or less likely to and then take that certificate to a Multnomah County in 2014, with about half frequently and at higher doses.” result in addiction,” said Deyo. But in terms pharmacist to obtain naloxone.” involving prescription opiates. In 2007, Purdue Pharma, the maker of of their addictive qualities or levels of safety, “The current law doesn’t allow this,” she The Centers for Disease Control and OxyContin, which is a high-strength version he said, “we don’t know really what the long said. Prevention estimates 46 Americans die of of oxycodone, was found guilty of term results will be.” Naloxone comes in several forms. There’s prescription opiate overdose every day - misbranding the drug by claiming it was less On Sept. 10, the FDA voted 23 to 1 an injectable version, a nasal spray, and even addictive than other opiates without any that’s almost one death every half hour. In against the approval of Purdue Pharma’s an auto injector that talks the person an effort to combat this nationwide evidence, and was ordered to pay more than newest opioid painkiller over concerns there administering the drug through the process. $600 million in fines and other payments. epidemic, the CDC created a grant program would likely be errors in administering the The more complex the medical device, the In Oregoq, unintentional prescription to help select states prevent opiate related drug, leading to overdose. more expensive it ■ opioid Naloxone has effectively reduced heroin deaths, and in September named Oregon gets, said Watt. “Cost hospitalizations overdose deaths in areas where it’s made one of 16 states to be awarded between has been one of the increased 285 available to intravenous drug users. In an $750,000 and $1 million annually in federal In Oregon, nnintentional percent between barriers.” interview with Street Roots in September, funds over the next four years. prescription opioid hospital 2000 and 2013, Most common is Kim Toevs, harm reduction manager for The grant coincides with coordinated the nasal adapter, and izations increased 2 8 5 percent according to state Multnomah County, said more deaths could efforts among health professionals already health authority some police be prevented if there were a way to get between 2 0 0 0 and 2013, underway in the Portland-metro region. On reports, with 156 departments around naloxone to prescription opiate users as Tuesday, Oregon Health Authority approved according to state health au Oregonians dying the state are keeping well. This, said Lewis, is another goal the its State Health Improvement Plan, which thority reports. from prescription it in their squad cars, collaborative will continue to work on. places opioid overdose as a top priority for opioid overdose or said Watt. the state. Among the plan’s targets is poisoning in 2013. “I actually saw it lowering prescription opioid deaths from 4 • “There are now far used once, and it’s just n Sept 23, CVS pharmacy announced it per 100,000 Oregonians to less than 3 per more deaths from prescription pill incredible,” he said, “the person was half is now dispensing naloxone without a 100,000. overdoses than there are from heroin,” said dead and all of a sudden - boink - they’re prescription at its retail stores in 12 Since June 2014, the Healthy Columbia Lewis. sitting up.” additional states - having already made the Willamette Collaborative, a workgroup Starting this fall, Lewis says the Portland- drug available in Rhode Island and composed of HealthShare, FamilyCare, area collaborative tasked with finding Massachusetts. More than 50 CVS health providers, hospitals and officials solutions to opioid abuses will begin the n 2013, the federal Substance Abuse and pharmacies in California will make the drug within Multnomah, Washington, Clackamas outreach phase of its plan by educating Mental Health Services Administration available. California passed a bill allowing and Clark county health departments, prescribes, patients and the public about reported Oregon had the highest rate of the drug to be sold without a prescription in including Lewis, has been developing safer opiate prescribing standards and prescription pain reliever abuse in the 2014, and CVS is the first pharmacy to stock guidelines and standards for prescribing overdose prevention. It will focus on the nation, with 6.37 percent of people 12 and the drug since the bill’s passage. opiates and looking at ways to reduce the guidelines its members agreed upon this older reporting they took pain relievers According to Michael DeAngelis, risk of overdose. summer. spokesperson for CVS, both the nasal and The tri-county area was one of the regions recreationally. Those recommendations include: screen Opioid prescriptions in the U.S. have injectable versions of the drug will be selected by Oregon Health Authority to for opioid risk and evaluate a patient’s increased four-fold since 1999, despite no available at participating pharmacies at a receive support from the CDC grant Both substance abuse history before prescribing change in the amount of pain Americans cost of about $40 to $50 per dose. the local collaborative and state health an opioid, refer those who become addicted report, according to the CDC. “What we’ve heard,” said Lewis, “is even authority are ramping up efforts this fall, during treatment to an addiction specialist Dr. Richard Deyo, a primary care when it’s legal, if pharmacies don’t stock it, with regional educational outreach and a or addiction treatment, consider a physician at Oregon Health and Science there’s no way for people to get it, so CVS statewide, two-year performance prescription for a naloxone rescue kit to University, has researched issues around improvement project aimed at improving high-risk patients, and discontinue opioids in seems to be filling that vacuum.” opiate prescriptions for approximately seven For this reason he said the collaborative opioid management favor of alternatives if goals are not met. years. He said the drastic increase in opiate will soon be asking local retail pharmacists At both levels, officials aim to decrease Deyo said there’s been a shift toward non- prescription rates correlates with a whether or not they would stock naloxone opioid prescriptions, reduce overlapping pharmaceutical approaches to treating marketing campaign. and what it would cost prescriptions and co-prescribing chronic pain, and treatments such as spinal “In retrospect many people would “Why don’t we make this life saving drug medications, and make naloxone, an opiate manipulation, acupuncture, massage, acknowledge the pharmaceutical companies easy to get to?” said Lewis. “You can look overdose-reversing drug, more widely physical therapy and exercise have seemed have had an important role in this,” says back and say, ‘Why didn’t we do it 10 years to have a greater effect in returning patients available. Deyo, “the most dramatic increase in opioid ago,’ and the answer is, ‘Yeah - 1 wish we Naloxone stops an overdose by blocking to normal functioning - and they’re safer. prescribing really began approximately 20 the opiate receptors in the brain. Someone had.’” As concerns over drugs like OxyContin years ago with the introduction of other than the person who is overdosing STAFF WRITER I O I
