Painkiller Rxs Rising, But So Are Deaths From Heroin

Aug 22, 2014

The state health department has just published some striking data on numbers of prescription painkillers, stimulants, and other controlled substances prescribed in Rhode Island over a 10 year period.

In January 2014, according to the health department, 1.8 million doses for painkillers were filled in Rhode Island. The numbers have been on a steady incline for 10 years. Check out the red line, below.

Credit Rhode Island Department of Health

That's lots of pills, lots of prescriptions, for lots of people. These are some of the most frequently prescribed medications and represent a multi-billion dollar industry nationwide.

The data raise many issues and questions, the first of which must be: do we need so many painkillers? But also:

  • How many people are taking these medications long term, and of those, how many get hooked?
  • Of the people who get hooked, how many end up turning to heroin because a) they can no longer get prescriptions from a doctor; b) the pills are too expensive on the street; and c) heroin is the same, chemically, as opioid painkillers, but much cheaper?
  • The health department data show that nearly 1200 Rhode Islanders (that we know of) have sought prescriptions from more than four doctors and/or more than four different pharmacies. While many people who are getting prescriptions for painkillers may legitimately need them and use them as prescribed, it's clear that there's plenty of non-medical use going on - and, likely, addiction.
  • This data has limitations. It doesn't capture the number of pills exchanging hands illicitly. It also may not reflect the activities of approximately three-fourths of the state's prescribers, who are currently NOT using the state's prescription monitoring database.

Rhode Island Hospital drug abuse epidemiologist Traci Green would say that the prescription monitoring database is perhaps only one place we should be investing resources if we want to prevent opioid overdose deaths. And that's really the whole point of making this data available. In fact, Green told me at a recent Governor's Task Force on Overdose Prevention meeting that prescription painkillers used to be behind the majority of drug overdose deaths in the state. Now, that's flipped. The major cause is now likely to be heroin. Green also says the number of people initiating a heroin habit has doubled. Here's more:

The good news? Lots of people in state government, health care organizations, universities, and community organizations are working on this problem. They're meeting regularly, sharing information, making some changes. I hear from experts in this field all the time that there's not one solution but many, and it involves all of us. They tell me doctors must take a look at their prescribing habits, patients must take a look at their own use of prescription painkillers. But most importantly, people dealing with the disease of addiction must be offered every opportunity to get into treatment, before it's too late.