Opioid Abuse & The Missing Information

December 3, 2015 • Prescription Drugs • Views: 4269

On any given morning I can open up my laptop and find probably half a dozen articles on our opioid abuse problem going on in the U.S.  The words in the headlines change, but the content and message are sadly always the same: Opioid and heroin addiction are rampant.

Sometimes the article is simply reporting the facts:

  • A pharmacy robbery in Oklahoma
  • A pain clinic closed in Tampa
  • A physician/pharmacist team exposed for pill mill prescribing
  • A grieving family over the loss of a loved one due to an overdose

Sometimes the article is trying to uncover solutions:

  • Focus on prescribers to solve the problem
  • Focus on pharmacies to solve the problem
  • Secure our borders to solve the problem
  • Open more recovery and treatment facilities to solve the problem
  • Educate the public to solve the problem        

Not only do we have lots of information describing the problem and proposing solutions, but we also have taken several steps to try and deal with the issue. 

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For example:

  • Nationwide Prescription Monitoring Programs and Mandatory Reporting
  • Naloxone emergency kits
  • Abuse deterrent narcotic formulations
  • Rescheduling of Hydrocodone to CII status
  • Improved prescription security (tamper resistant prescriptions, mandatory electronic prescribing is coming soon)

But something about all this information and activity has always bothered me.  Something is missing in all our reporting about overdose deaths.  I feel like I’m trying to solve a puzzle with a missing piece. 

What is missing is data that traces the prescription medication involved in the death back to the source

In other words, to put it bluntly:  Where did the victim obtain the drug?  Who gave it to him/her?  That information is almost never revealed. 

We NEED to know where the drugs involved in DEATHS are coming from. The source is significant!  But everything we read online is typically general and non-specific.  We’re told we have a “diversion” problem and an “overprescribing” problem and that prescription opioids are being “stolen” and “sold.”  That’s not data.  That’s not research.  We have thousands of these terrible overdoses going on every year, but frankly we have NO reliable data upon which to design our strategy.

For example (this list is not comprehensive), did the medication involved in the overdose death come from…

A)  A legally obtained prescription for themselves by a doctor and pharmacy

B)  A stolen bottle of medications from an otherwise legally obtained prescription (e.g. from a friend or family member)

C)  An illegally purchased bottle of prescription medication on the street or from a pharmacy

D)  A fake or stolen prescription blank

E)  An emergency room prescription

F)  Pharmacy theft

G)  Unknown?

Can you see how the SOURCE of the offending substance should logically determine our strategy for correction?  But if you happen to have read the article this far (you are a hearty soul!), I warmly invite you to search online for this data.  Google it.  Look for studies.  Search for hard data, not “general” lists of possible sources for opioids that lead to addiction and death.  Actual numbers.  Percentages.  Figures.  Find the study that says “___% of overdose deaths came from prescription drugs obtained legally by the victim from his/her doctor, and ___% came from illegally purchased prescription drugs from an illicit source.”  Once you find that study, please send it to me.  I’m eager to see it.

Maybe you will have more success than I have had.  I can’t find that information.  Maybe I’m not that good at doing online research.  I will gladly concede that fact if someone can come up with answers and data that is verifiable. 

Maybe the sad reality is that the answer is unknown.  Maybe we have no idea where the drugs are coming from.  Maybe these awful deaths are made even more terrible by the deafening silence of information about how the poor victim obtained their lethal dose. 

If so, that breaks my heart.  And if that is the case, I’m not very optimistic about our efforts to combat this growing crisis.

©Jason Poquette and The Honest Apothecary.  Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts, quotes and links may be used, provided that full and clear credit is given to Jason Poquette and The Honest Apothecary with appropriate and specific links to the original content.


 

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Author: Jason Poquette

3 Responses to Opioid Abuse & The Missing Information

  1. Pharmaciststeve says:

    There is more “vagueness” that is being used out there.. I am seeing a change in the nomenclature both addicts and those who have a longer term medical need for opiates (chronic pain) are now being lumped together as “opiate use disorder”. Likewise, seeing fewer and fewer “accidental drug overdose” .. we now have “opiate related deaths”.. Now they can increase the numbers of those with “opiate use disorder” and increase the number of deaths contributed to opiates.. with labeling the death as a opiate related death.. even if there was not a lethal amount of opiates in their system and even if there is only a therapeutic level. They are also implying that there are 46 K drug overdose deaths, but they seldom mention that nearly HALF are from OTC meds.
    IMO, this all is part of the need for increased “numbers” as states are decriminalizing or making MMJ/MJ legal and the basic goal of a bureaucrat is to perpetuate and grow the bureaucracy. As the DEA loose all those MJ arrests.. they need numbers to justify their budget requests. After all, we have spent over ONE TRILLION since 1970 and continue to spend 51 BILLION annually fighting the war on drugs… and the DEA is only able to confiscate 1% of which gets to the streets.

  2. Joy says:

    I can tell you this, I have filed formal complaints regarding Toxic Oxycodone prescriptions, the most recent complaint was with Human Rights Watch. The first “return”, [the pharmacist owed me a balance], was KVK brand. I was terrified as it almost gave me an aneurisym. I could place my index finger and thumb on the left side of my head-where a blood vessel felt like it was about to explode. I have had severe side-effects from Activis, Qualtest, Malenkrodt, Malenkrodt-Name Brand Roxicodone, all of which contained a sleep depriving component added to them, Raised blood pressure, muscle cramps, weight gain, headache, agitation, left-sided bruxism. It’s unbelievable to have to pray to God that the one small part of the pill will help with my pain w/o the counter-effective-side effects.. All of these pills fizzle i before I can bring water to my mouth. I have been in search of a compounding pharmacy whose cost I can afford,, but I havn’t had any success. I’m in constant fear because my rheumatologist said that the CDC wants everyone with chronic-illness off opiate pain meds, even cancer patients !! I told both disability advocates, and Human Rights Watch that I don’t believe people are overdosing on oxycodone at all; I said I’m here to tell you that these legally prescribed “Oxycodones” have almost killed me, that there is something very dangerous in them. I also tested positive for heavy metals.

    • jasonpoquette says:

      Hi Joy. I’m sorry for your experience and I hope you find some answers. It is important to understand that hundreds and thousands of patients use these drugs every day with few side effects and improved quality of life. Everyone’s experience is different, which is why we use large-scale studies in research.

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