Report: States lack strategies to curb prescription drug overdoses


McClatchy Washington Bureau

Prescription-drug overdose deaths have risen sharply in recent years, and a majority of states are not implementing the best strategies to curb them, according to a new report from a health-care advocacy group.

The report from the Washington-based Trust for America’s Health, which was released Monday, found that 28 states – including Alaska, Pennsylvania and Texas – and the District of Columbia had put in place six or fewer out of 10 promising strategies to lessen prescription drug overuse.

According to the report, prescription drugs are now to blame for the majority of fatal drug overdoses in the U.S., surpassing the number of deaths related to heroin and cocaine combined. Since 1999, overdose deaths from all kinds of drugs have at least doubled in 29 states, and in 10 of those – including South Carolina, Mississippi, Missouri and Georgia – the rate has tripled. In Kentucky, the rate has quadrupled.

“This is a very real epidemic – and warrants a strong public health response," Andrea Gielen, the director of the Johns Hopkins Center for Injury Research and Policy, said in a statement accompanying the report’s release.

The study acknowledges that prescription -drug overdose deaths have grown so quickly that extensive research is lacking on the best ways to prevent them. Even so, a range of methods have been developed based on recommendations from medical, public health and drug prevention experts.

Florida, for example, is proof that a comprehensive approach can lead to improvement, according to the report.

By initiating a range of public health strategies and legislative changes – such as starting a prescription-drug monitoring program and closing “pill mills,” which prescribe and dispense drugs outside the usual standards of medical practice – Florida saw a decrease in prescription drug-related deaths in 2011, the report said. Deaths from oxycodone, a powerful narcotic, alone decreased by more than 17 percent.

The majority of states, though, have been slow to implement strategies.

Only two states, Vermont and New Mexico, scored 10 out of 10 on the indicators the group examined. Four states scored 9 out of 10, including Washington and Kentucky. California, Illinois and North Carolina were among the 11 states that scored 8 out of 10. Five states, including Florida, scored 7 out of 10. Missouri and Nebraska scored 3 out of 10, and South Dakota scored the lowest, with just 2 out of 10 indicators.

Monitoring programs such as the one Florida started are one strategy states can use. According to the report, they can “help identify major sources of prescription drug diversion such as prescription fraud, forgeries, doctor shopping and improper prescribing and dispensing.”

While nearly all states now have such monitoring programs, the report found that they vary dramatically in terms of their funding, use and capability. Only 16 states, for example, require medical providers to use the programs. The District of Columbia has legislation pending to start a program; Missouri is the only state without any at all.

According to the federal Centers for Disease Control and Prevention, bolstering these programs could lead to significant reductions in overdoses, since more than 3 out of 4 people who misuse prescription painkillers use drugs prescribed to someone else.

States also were evaluated in the report on whether they have a requirement that people show identification when picking up prescriptions, along with whether a physical exam was required, whether there was support for substance abuse services and whether there was a pharmacy lock-in program, which requires suspected abusers of controlled substances to use single prescribers and pharmacies.

States such as Kentucky indicate how quickly this epidemic has progressed: While it scored 9 out of 10 in the report’s indicators, it also has the third highest death rate from overdoses due to all kinds of drugs.

“Some places have higher rates of prescribing than others, and also the actual deaths from overdoses tend to be higher in rural communities,” said Laura Segal, a public affairs official with the group.

“A lot of the policies and strategies to try to reduce (the epidemic) are just starting to be put in place, so they are often relatively new, which accounts for some of the lag,” Segal said. “Public health officials expect as more of the strategies are put in place and implemented, that we’ll start seeing more results.”


Read more World Wires stories from the Miami Herald

In this Friday, Aug. 22, 2014 photo, Irom Sharmila is detained by policewomen in Imphal, in the northeastern Indian state of Manipur. The frail Indian activist who has been on a hunger strike for nearly 14 years to protest alleged military brutality scuffled with police Friday as they took her back to the same government hospital where she had been force-fed. Sharmila, 42, vowed to continue the hunger strike that landed her in prison for the past 14 years. She walked free on Wednesday after a court threw out the charges of attempted suicide against her. Attempted suicide is a crime in India. (AP Photo/Press Trust of India) INDIA OUT

    India police re-arrest fasting activist

    A lawyer says police have re-arrested a frail Indian activist who has been on a hunger strike for nearly 14 years to protest alleged military brutality in India's remote northeast.

  • Russian aid trucks begin to leave Ukraine

    Some of the trucks in a Russian aid convoy that entered Ukraine in a move denounced by Kiev as an invasion are returning to Russia.

  • China shuts down Beijing Independent Film Festival

    Chinese authorities shut down an independent film festival on its opening day Saturday, a rare venue for the showing of films that may be critical of the government in a country with tight controls, organizers said.

Miami Herald

Join the

The Miami Herald is pleased to provide this opportunity to share information, experiences and observations about what's in the news. Some of the comments may be reprinted elsewhere on the site or in the newspaper. We encourage lively, open debate on the issues of the day, and ask that you refrain from profanity, hate speech, personal comments and remarks that are off point. Thank you for taking the time to offer your thoughts.

The Miami Herald uses Facebook's commenting system. You need to log in with a Facebook account in order to comment. If you have questions about commenting with your Facebook account, click here.

Have a news tip? You can send it anonymously. Click here to send us your tip - or - consider joining the Public Insight Network and become a source for The Miami Herald and el Nuevo Herald.

Hide Comments

This affects comments on all stories.

Cancel OK

  • Marketplace

Today's Circulars

  • Quick Job Search

Enter Keyword(s) Enter City Select a State Select a Category