Prescription drug deaths fall in Oregon, but heroin deaths still rising

By Stuart Tomlinson, The Oregonian, June 4, 2013

Every year about this time, Dr. Karen Gunson, the Oregon state medical examiner, and her colleagues tally up drug-related deaths in the state. And each year, Gunson sees trends in the numbers.

For 2012, Gunson said, she saw that the ages of victims of heroin overdoses were predominately people in their 20s — younger than in years past.

She also saw that while the numbers of drug-related deaths in rural counties were much lower than in populous Multnomah County, the deaths in rural areas had something in common: They took place in towns close to interstates or major highways, which act as blacktop pipelines.

READ – Multnomah County inmate died of heroin overdose, jail officials investigate source of drugs, Oregonian, June 6, 2013

“We are also seeing a trend – and the police would agree – of people who were addicted to prescription opioids turning to heroin because they can’t get their prescriptions filled or can’t afford to pay the street price,” Gunson said. “They can get the heroin cheaper, but they don’t know how to take it or its potency.”

The number of people who died from illicit drugs last year dropped 7 percent from 2011, but heroin-related deaths rose again, to 147.

Prescription drug deaths – usually related to misuse and abuse of legitimate drugs prescribed by a physician – saw a decline last year. Gunson said it appears the dip is the result of the state’s prescription drug monitoring program.

In all, 223 people died of illicit drug overdoses, the third highest total ever in the state, with only last year (240) and 2008 (229) having more deaths.

Gunson said even though the total numbers reflect a drop in drug deaths statewide, two counties – Jackson and Marion counties – saw heroin overdose deaths nearly double. Jackson County increased from nine deaths in 2011 to 19 last year while Marion County rose from 10 deaths in 2011 to 19 last year.

Statewide, heroin deaths accounted for 65 percent of all illicit drug deaths, and about half of all Oregon drug-related deaths occurred in Multnomah County.

Gunson said cocaine deaths showed a significant decrease last year over the year before, with 19 deaths, down from 33 in 2011. Methamphetamine deaths also decreased, down to 93 from a high of 107 in 2011. Still, methamphetamine overdoses were solely responsible for all drug deaths in eight mostly rural counties.

“There is nothing to celebrate in these numbers because these are real people needlessly dying from the abuse of illicit drugs and prescription medications,” Gunson said.

The state also tracks deaths related to prescription drug use, and last year, 170 people died from prescription drugs, with methadone-related deaths at the top of the list with 78, a 20 percent drop from the year before when 100 people died.

Hydrocodone deaths also dropped, from 37 in 2011, to 26 last year. Oxycodone deaths rose from 56 in 2011 to 66 last year.

According to the Oregon Health Authority, hydrocodone and oxycodone were the two top opioid drugs prescribed in Oregon in 2012. More than 3.1 million prescriptions were written from January through December, accounting for 46 percent of all controlled substance drugs prescribed.

That’s enough opioids for every man, woman and child in the state to get one, or about 100 million doses, all legally prescribed, in a 12-month period. Officials say these two drugs and other opioids have the highest potential for addiction, misuse and overdose.

Gunson credited the drop in prescription drug deaths to Oregon’s Prescription Drug Monitoring Program, which went into effect in September 2011. The program was designed to allow doctors to identify and address potential abuse problems in patients.

Tom Burns, director of the Oregon Health Authority Pharmacy Programs, said the program allows doctors and pharmacists to easily access a patient’s prescription history.

“If the doctor sees you received the same prescription from a different doctor three days ago, the doctor may not write another prescription,” Burns said. “It means there will be fewer drugs out there for people to overdose on.”

Burns said most patients get the drugs legitimately, go back for more because they get pain relief and then suddenly find they are addicted. Then the doctor cuts them off, and they might turn to heroin because it’s cheaper. On the street, oxycodone or hydrocodone costs about $1 a milligram, or as much as $100 for one tablet, he said.

“That’s a serious problem,” Burns said. “It’s a tragedy they got addicted but we need to have better treatment programs so they don’t turn to the streets.”