NH AG Kelly Ayotte is demonstrating a common myopia (shared by the nation as a whole) when it comes to dealing with the rising rate of prescription drug abuse. She wants to create a database to help track stimulants, pain killers, muscle relaxants and other commonly abused prescriptions in the state in an effort to reduce the rising number of deaths associated with this form of abuse. Some claim the database poses privacy issues, while others contend that there are complex government regulations and a full blown pissing match between physicians and Pharmacists over who should be monitoring for abuse, and who is ultimately responsible when the system fails.
I contend that all of these things are true to some degree, but we can probably avoid most of them, and prevent the extensive costs to taxpayers of setting up and monitoring such a system, by simply looking at some obvious relationships (at least in New Hampshire) and connecting the dots. Get the complete dope on the jump.
Let’s start with the article from the Union Leaderin which Ms. Ayotte, in response to the rising number of reported deaths from prescription abuse last year states that
New Hampshire is the only state in the region that does not keep a central database. In all, 35 states keep track. In Maine, more than nine out of 10 database checks are by doctor offices. The rest come from pharmacies and police, Ayotte said.
“It’s a public health issue and a way that will allow pharmacists and physicians to get the information they need, so they are not over prescribing,” Ayotte said.
Well that just begs for further inquiry.
The States (New Hampshire’s) Medical Examiner reported to WBZ that 57% of the 168 deaths from prescription drug overdose were caused by methadone, a drug typically prescribed to Heroin Addicts to “assist” them in escaping their addiction to Heroin.
But according to this report in the Concord Monitor it is not addicts under methadone treatment that are dying.
Methadone is prescribed to help addicts overcome heroin addiction and as a painkiller. Officials say it is not the liquid methadone dispensed to addicts at clinics that is causing the overdose deaths but the tablets prescribed by doctors to relieve pain
From which I must conclude that 95 of the 168 deaths in New Hampshire (57%) were related specifically to methadone prescriptions for pain relief. Looking back to the Union Leader quote Kelly Ayotte ignores the obvious soution and instead points us toward Maine for a remedy. But what of Maine’s remedy?
And for the record, at least up to 2005, all the New England states (whom we are to understand have a database similar to Maine) show increasing death rates from methadone use or abuse. (see CDC link and tables for details)
It has been difficult to determine the extent to which increases in opioid-related deaths have been due to specific prescribing practices, improper taking of the medication by patients, diversion of the drug from the patient to someone else, or other means. In July 2007, a SAMHSA-sponsored conference on methadone mortality concluded that all forms of methadone distribution (tablets, diskettes, and solution) continue to rise, with the greatest rise in distribution coming from tablets distributed through pharmacies;…
Kelly thinks a database will help. Yes, more intrusive and complex government regulations and oversight is certainly a far better coarse of action than halting the administration of a medicine that can be directly linked to 95 deaths in 2007, in the State of New Hampshire alone.
Where’s the outrage?
We can argue about the complex nature of the relationship between opiates and their users but dead is dead.
-Methadone is more difficult to dose as a pain reliever because of its half life in our systems relative to its pain relieving capacity.
-Users cannot simply take more of it if the prescribed dose does not do the job because it could simply kill them.
-We know that prescriptions for methadone as a pain reliever account for the largest increase in the drugs use.
-Abuse is increasing as are deaths.
And finally, 57% of the 168 overdose deaths in NH have been linked directly to abuse or misuse of a methadone pain relief tablet. You want a database? How about the one that shows us how many people will die as a result of ignoring the actual problem?
Or is that realtionship just too complex?