DailyRecord.com: Symposium targets painkiller 'epidemic'
6/14/2014
MORRISTOWN – The dangers of driving, especially while intoxicated, are well-documented but no longer represent the most common cause of accidental death in New Jersey.
The most life-threatening danger we face, say local, state and federal law-enforcement authorities, is not behind the wheel, and may be stored in a bottle in your medicine cabinet at home.
"In 2010, enough prescription painkillers were prescribed in the United States to medicate every adult American, every four hours, for a month," Paul Fishman, U.S. attorney for the District of New Jersey, said Tuesday at Morristown Medical Center. "Think about that. In the year 2000, just 14 years ago, retail pharmacies dispensed 174 million opioid prescriptions, In 2009, 257 million, an increase of almost 50 percent."
In between, in 2007, drug overdoses became the No. 1 cause of accidental death in New Jersey.
Fishman was speaking at Morristown Medical Center, the site of the first of three "Do No Harm" symposia coordinated by the Partnership for a Drug-Free New Jersey with the New Jersey division of the Drug Enforcement Administration, the High Intensity Drug Trafficking Area program of New York and New Jersey, the state's Attorney General office and the Medical Society of New Jersey.
The program is being conducted this week in recognition of Gov. Chris Christie designating the week of June 9-13 as Opioid Abuse Awareness Week. It continues today at the Community Medical Center in Toms River and concludes Thursday at Cooper University Hospital in Camden.
"The way we deal with medicine in our homes has become an enormous problem," Fishman said. "I don't think I'm being hyperbolic or dramatic when I say there's actually an epidemic in the United States that is responsible for huge personal tragedy, widespread suffering and enormous personal loss. It is one of the biggest dangers in our communities that we face, whether they are rich or poor, urban or suburban, in the north or in the south. ... That epidemic leads to addiction, accidental death and violence, real violence in our streets, as well as huge amounts of lost revenue."
The returns from successful community take-back programs, which allow people to turn over expired or unused prescription medications to local authorities for proper disposal, are measured in tons, according to Russell Holske, chief of the pharmaceutical investigations section of the DEA Headquarters Office of Diversion.
Yet millions of opioid painkillers and other potentially dangerous pharmaceuticals still end up being abused by both patients and those who obtain them illegally, resulting in about 100 deaths per day, according to Michael Botticelli, acting director of the White House Office of National Drug Control Policy, who welcomed the assembly in Morristown via satellite video.
"Fifty-two million Americans over the age of 12 have used prescription drugs for a non-medical use," Fishman said. "Two and a half times more Americans abuse prescription drugs than the number of people using cocaine, heroin and inhalants combined."
The result, according to Fishman, is that 40,000 or more Americans die annually due to drug overdoses. Nearly 60 percent of those are from pharmaceutical drugs, he said, and opioids are involved in three-quarters of the pharmaceutical overdoses.
According to a recent report by the Trust for America's Health, the rate of drug overdose deaths in New Jersey has increased by 51 percent since 1999, from 6.5 per 100,000 to 9.8 per 100,000 in 2010. The same report ranks 11th among states in annual drug overdose deaths. Nationally, rates have doubled in 29 states since 1999, quadrupled in four of states and tripled in 10 more.
Another problem presented by opioid-based prescription painkillers, according to symposium speaker Dr. Sindy M. Paul, medical director for the New Jersey Board of Medical Examiners, is that they have contributed to the recent surge in the use of perhaps the most dangerous opioid drug — heroin.
"It's a less-expensive analogue of prescription medicine that delivers a stronger high," she said.
"A tab of (oxycodone) can cost $25 on the street," Fishman said. "You know what's cheaper? Heroin."
According to a 2013 report by the Daily Record, a single Percocet pill on the New Jersey black market will sell for $20 to $80. But a single bag of heroin, containing .01 gram of powder, will go for $3 to $10.
"A bag is cheaper than a box of cigarettes, cheaper than a six pack of beer, so a lot of kids are experimenting with it," said Sgt. John-Paul Beebe of the Sparta Police Department.
The symposium panel included medical, law-enforcement and legal professionals talking about related topics, including the physician's responsibility to treat patients who clearly are attempting to obtain opioids by fraud.
"We need your help," Fishman told the physicians. "We would like you to think carefully how you prescribe. Does a person who broke a finger really need 30 or 40 pills? Talk about this with your patients and tell them them how to store them, tell them about take-back programs. That will save lives. Because people in our society don't think of medicine as a drug in the way they think of heroin or cocaine. ... We are too cavalier about the access to these things and less cautious about supervision."
Fishman and others encouraged physicians to sign up for the state prescription-drug monitoring program (which allows doctors to track a patient's prescriptions) and said he supports making membership in the PMP a condition of employment.
But Dr. William B. Felegi, chairman of Morristown Medical Center's Department of Emergency Medicine, cautioned the legislators in the crowd not to pass laws that would inhibit their ability to care for patients with mandatory PMP registration.
"You have to think about unintended consequences," he said. "If you're in the emergency room and seeing patients every 10 minutes, and the last two patients have broken ankles, do you really have to take the time to check the PMP when their leg is hanging off the table? Sometimes our legislators have very good intentions, but they don't write very good bills."
Felegi also endorsed prescribing to chronic users a controversial drug called naloxone, which is delivered via injection or inhalation and can counteract the effects of opioid overdose in an emergency.
Staff Writer William Westhoven: 973-428-6627; wwesthoven@dailyrecord.com