Pain meds runner-up to weed

By Mike Ford, The Delphos Herald
Published:  Monday, May 5, 2008 (2 months, 2 weeks ago)
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From “junk” to “rock” and “wacky weed,” drugs like heroin and cocaine have been nationwide problems for many years. However, prescription medications are now the second-most abused narcotics in the country. Marijuana tops the list.
Bill Winsley is the executive director of the Ohio Board of Pharmacy. He says there was a time when pain was undermedicated and doctors have been under pressure to offer patients more relief. However, doing so has led to a medicated culture in which pills are peddled on the street and in high school hallways.
“Teenagers are getting into the medicine cabinet and the thought is if it’s a government-approved product, it’s OK to take three instead of one. We are being taught that it’s OK to take a pill for whatever we need. As a result, the Office of National Drug Control Policy out of the White House released information a couple years ago showing that prescription drugs are No. 2 on the street behind marijuana. They’re ahead of LSD, cocaine and heroin combined. It’s becoming a major problem,” he said.
Winsley’s agency launched a program in late 2006 called the Ohio Automated Rx Reporting System (OARRS). Most medical offices in Ohio do not use the system but area pharmacies rely on it to police abuse. They report prescriptions to the state, compiling an information database they can access when customers bring in prescriptions.
Delphos Discount Drugs uses the system and catches a lot of residents trying to obtain narcotic pain medications such as Oxycontin, Vicodin, Darvocet and Percocet.
“We file a narcotics report with the state every two weeks, so these drugs can be monitored when a customer goes to multiple doctors and multiple pharmacies. There’s a record and they will get caught. We have access and can look up information to see if they just had it filled the day before at another pharmacy. You wouldn’t believe — just in Delphos — how many people we have caught this way,” explained Pharmacist Angela Eickholt.
However, “scripts” still hit the street, becoming law enforcement’s problem.
Delphos Police Sgt. Kyle Fittro spent nearly five years with the West Central Ohio Crime Task Force and says pain medication abuse is the fastest-rising narcotics crime.
“Oxycontin and Vicodin are the two most popular pharmaceutical drugs. In a couple of years, we went from them barely being a blip on the radar to widespread abuse and the prosecutor is taking notice because we found people committing some of the same spin-off crimes they commit with crack cocaine,” he said.
Fittro and Delphos Police Chief Dave Wagner agree that Oxycontin, especially, seems to be associated with other crimes.
“We have a lot of break-ins and a lot of times, their script medicines are all that’s missing. Obviously, someone knows someone has a bad back and is getting Oxycontin, so to them it’s worth breaking in to,” Wagner said.
The chief does not believe the majority of local teens use pain medications to get high. However, Fittro indicates some elder citizens on a fixed income are tempted to sell some of their pills to offset the expense.
“The profit margin is just outrageous if you get the medications free through insurance and can turn around and sell them for what they sell for on the street — about $1 per milligram; sometimes they might catch a break and an 80-miligram pill might go for $60. As long as there’s money to be made, script abuse will continue to be a problem,” he continued.
Apart from an undercover sting operation or a tip from a pharmacy, catching abusers is uniquely challenging for law enforcement. Wagner says it is impossible to know how much is really going on if it remains within an individual family.
He says pain medication abuse constitutes approximately 25-30 percent of his drug cases. Van Wert County Sheriff Stan Owens reports the same, as do officials in Putnam County.
Sgt. Mike Chandler is with the Multi-area Narcotics Unit. Like other places, Putnam County has a problem with “doctor shopping.”
“A lot of them are going to different doctors and getting prescriptions for the same medication. The most abused prescription drug is Vicodin. Then, it runs the gamut — Darvocet, Percocet, Xanax and Oxycontin. People lie to the doctor about symptoms to fraudulently obtain the prescriptions and most of the time, doctors are pretty good about letting us know if there’s a problem with a patient,” he said.
Chandler says availability makes the difference in which pain reliever is most prevalent. He also says they cycle among the most agressively-marketed brands.
If medications are taken according to a doctor’s instructions, Eickholt says residents are unlikely to become addicted. She describes how narcotic medications are classified.
“You don’t see ‘schedule 1’ drugs because they’re experimental. Schedule 2s are drugs like Ritalin, Addrall, Percocet and Darvocet that are the most addictive and the most controlled. There are no refills on those; you have to go back to the doctor each time. Schedules 3s and 4s are controlled substances and are narcotics but refills are allowed and limited. They aren’t as addictive as schedule 2s. Then, schedule 5s are drugs you have to sign for, like codeine cough syrup. We have people who get that but they don’t take a teaspoon, they drink the whole bottle,” she explained.
Eickholt says it becomes a problem if a teen steals a family member’s medications because the customer may need an early refill, which pharmacists cannot perform without the doctor’s authorization.
If this problem occurs, residents should consult the respective physician and address the other issue separately.
The Ohio Automated Rx Reporting System is steadily becoming part of doctors’ daily practices. Winsley says the program works very well when it is used.
“If the doctor looks at OARRS ahead of time, the doctor is going to know the patient has seen several other physicians. The overwhelming number of physicians, at that point, would pull back and say ‘wait a minute; there’s a problem here’,” he added. “Physicians are the largest group requesting reports from us. About 80 percent of our requests come from doctors and we do about 1,100 reports a day.
“In the grand scheme of things, the overwhelming number of physicians licensed in Ohio are not signed up to access it but word of mouth is getting the word out about it.”
He also says doctors do not receive “kick backs” from drug manufacturers, which would violate federal law.

Look for an upcoming story on marijuana in the Delphos Herald

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  1. #1 — Added 2 months, 1 week ago

    Case studies of specialty patients and two population studies suggest that headache is associated with sleep disorders in general, including sleep-disordered breathing. Sleep-disordered breathing has also been strongly associated with cluster headache. However, the risk of CDH associated with snoring has not been assessed in a population sample.

    Posted on May 8, 2008 at 3:08 am by james