Spread the Word … One Pill Can Kill

You take one pill to get up, to focus, to get the job done. But then you need something to relax you, to calm you down, so you take another pill. … It’s a slippery slope to addiction. ~ Stephen Haydon

The New Face of Addiction is an article by Diablo Magazine, a northern California publication.

The article talks about a suburban mom who shared how her teenage daughter got hooked on prescription pain medications.

This young teen was a “happy, social girl in elementary and middle school until she went to high school, and things began to change. The pressure to get top grades, to be popular, to be on the fast track for admission to a top college was overwhelming.”

The teens’ mother, thinking she was helping, took her daughter to a doctor who prescribed Klonopin for her daughter’s anxiety.

One pill led to another. Grades began to slip, and a new group of friends entered the picture. The parents knew something was wrong but didn’t understand what.

For example, a young teen may often do anything for the next high. She steals pills from friends’ parents’ medicine cabinets and from anyone who has a prescription. When those sources dried up, she turns to dealers for more pills. Her life is in jeopardy as she continues down the slippery slope of prescription drug use. Luckily, the young teen at the end of the article was now working to rebuild her life.

This teen’s story is not the only story. Unfortunately, too many young high school and college students are trying pills to fit in, get ahead, stay focused, or curb their anxiety. Some get help for their problem. Yet, others are not so lucky.

California has declared March as Prescription Drug Abuse Awareness Month.

This measure would proclaim the month of March, each year, as Prescription Drug Abuse Awareness Month and encourage all citizens to participate in prevention programs and activities and to pledge to ‘Spread the Word … One Pill Can Kill.’

Here are some facts about Prescription Drug Abuse that are listed on California’s Legislative Counsel’s Digest:

• In 2008, drug overdoses in the United States caused 36,450 deaths, and 20,044 of these were from prescription drug overdoses;
• Overdose deaths involving opioid pain relievers (OPR) have increased and now exceed deaths involving heroin and cocaine combined;
• In 2009, 1.2 million emergency department visits were related to misuse or abuse of pharmaceuticals (an increase of 98.4 percent since 2004);
• Nonmedical use of OPR costs insurance companies up to $72.5 billion annually in health care costs;
• By 2010, enough prescription painkillers were sold to medicate every American adult with a typical dose of five milligrams of hydrocodone every four hours for one month;
• In 2010, 2 million people reported using prescription painkillers nonmedically for the first time within the last year–nearly 5,500 a day;
• 70 percent of people who abuse prescription drugs get them from a relative or friend instead of a doctor;

A couple of years ago, I attended an informational hearing through the California State Senate Public Safety Committee on preventing prescription drug abuse of opioid painkillers. I posted this information at the time, but it is worth repeating.

Danny Santiago, Special Agent Supervisor, California Department of Justice, Bureau of Narcotic Enforcement, presented some eye-opening statistics and information.

Addiction steals one’s morals and ethics:

• 5-7% of the population is actively addicted
• 20-30% of active addicts primarily abuse prescription drugs
• Approximately 15% of non-triplicate narcotic prescriptions are fraudulent.
• Addiction recognizes no social-economic boundaries.

How big is the problem?

• At any given time, 7% of adults are impaired.
• 60% choose alcohol — Approximately 45% want Rx Meds — Less than 30% want street drugs
• Deaths from prescription painkillers have reached epidemic levels in the past decade. The number of overdose deaths is now higher than those of deaths from heroin and cocaine combined.
• In 2010, about 12 million Americans (age 12 or older) reported nonmedical use of prescription painkillers in the past year.
• Enough prescription painkillers were prescribed in 2010 to medicate every American adult around-the-clock for a month.
• Improving the way prescription painkillers are prescribed can reduce the number of people who misuse or overdose from these powerful drugs while making sure patients have access to safe, effective treatment. (CDC Vitals Signs November 2011).
• The number of prescription painkillers sold to pharmacies, hospitals, and doctor’s offices was four times larger in 2010 than in 1999.
• The unprecedented rise in overdose deaths in the US parallels this 400% increase since 1999 in the sale of these strong painkillers.
• Nearly three out of four prescription drug overdoses are caused by prescription painkillers — also called opioid pain relievers.
• Most prescription painkillers are prescribed by primary care and internal medicine doctors and dentists, not specialists. Roughly 20% of prescribers prescribe 80% of all prescription painkillers. (*CDC Policy Impact: Prescription Painkiller Overdoses)
• Prescription opioid painkillers are now the 2nd most abused drug in the United States, second to marijuana.
• Emergency Room visits for the overdose of illicit drugs has remained the same since 2004.
• Emergency Room visits for the overdose of opioid painkillers has doubled since 2004 and surpassed visits for the overdose of illicit drugs.

Organized crime

Here is how organized crime encourages prescription drug use. Those pushing prescription drug use find “dirty” doctors who are willing to write prescriptions for opioid painkillers and a pharmacy or pharmacists ready to fill the prescriptions.

They find and pay “patients” to obtain those prescriptions, patients who have insurance of Medi-Cal or Medi-Care. The patients take prescriptions to pre-arranged pharmacies. Pills are then given to the Drug Trafficking Organization (DTO) and are sold on the street.

If DTO pays retail for the prescription, they make an 800% profit. If DTO obtains a prescription through insurance, they make an even higher profit by getting reimbursement through the “dirty” pharmacy.

An example of a money-making enterprise

• Suspect pays the doctor $1000 for ten prescriptions for 120 pills each of the opioid painkiller Oxycontin (80 mg).
• Suspect takes prescriptions to 10 different pharmacies and pays retail for pills.
• Oxycontin retails for $4.71 per pill. Suspect receives 1200 tablets from the 10 Rx’s.
• ]Suspect sells the pills for $20.00 per pill to a broker, making $15.29 per pill.
• $15.29 x 1200 = $18,348.00 — $1,000 to doctor = $17,348 profit
• The broker (suspect #2) sells the pills to a dealer in the Midwest for $40.00.
• $20.00 x 1200 = $24,000 profit for suspect #2
• Dealer (suspect #3) in Midwest sells the pills for $80.00 each on the street.
• $40.00 x 1200 = $48,000 profit for suspect #3
• $89,348 in profit for only 1200 Oxycontin pills

Opioid pain killer transition to heroin: 

Prescription drug use leads to heroin. A young adult gets addicted to an opiate painkiller. They cannot afford the pain killers any longer, and they cannot afford doctor visits.

A doctor is not willing to prescribe opioid pain killers at the rate they are taking them. They cannot find family/friends/acquaintances that have opioid pain killers in their medicine cabinet. Soon, they realize that heroin is an opiate with the same effects as an opioid painkiller. It’s easier to get and cheaper to buy.

A young adult has now become addicted to heroin.

The health impact includes Hepatitis, HIV, AIDS, overdose, and death. A rise in heroin overdoses will be seen in the next two years.

Impact on community

Overall there is a lower quality of life. With the current rate of this epidemic, every family will be affected by prescription drug addiction. There will be higher insurance premiums and more people under the influence.

What can be done statewide and nationwide?

• Maintain staffing and budget for CURES (The state’s database known as the Controlled Substance Utilization Review and Evaluation System, which contains over 100 million entries of controlled substance drugs that were dispensed in California. Other states have similar programs.)
• Create additional Prescription Drug Task Forces
• Routine monitoring of insurance claims
• Provider (doctor) education in recognition of prescription drug abuse
• Immediate sanctions and discipline for professionals

Here are seven things you can do:

1. Educate yourself about the dangers of prescription drug abuse.
2. Keep your medications in a safe place where others will not have access to them. Keep track of the number of pills you have been prescribed.
3. Next, ask your doctor for the fewest pills required when prescribed medication. You can always get a refill.
4. Doctors, many well-meaning, are offering prescription pain medication for symptoms that can be handled by an over the counter medicines. Use over the counter medicines for pain whenever possible.
5. Rather than having a written prescription, ask your doctor to call it in to the pharmacy.
6. Carefully dispose of your leftover medications. Please do NOT leave them in your medicine cabinet. Check for annual and semi-annual take-back days in your city. You can also safely dispose of your medications when you mix them with another substance, such as old coffee grounds. For a drop off location in the San Francisco Bay Area, visit sfenvironment.org/recyclewhere.
7. Finally, be aware and get help if you suspect friends or family members may have taken prescription or street drugs.

To learn more, visit The Medicine Abuse Project and the National Coalition Against Prescription Drug Abuse.

Remember, “one pill can kill.”

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