Pubdate: Mon, 30 Jun 2008
Source: Journal and Courier (IN)
Copyright: 2008 Federated Publications, Inc
Contact: http://www.jconline.com/services/forms/letter_to_editor.shtml
Website: http://www.jconline.com/
Details: http://www.mapinc.org/media/1691
Author: Tim Evans
Referenced: The study http://drugsense.org/url/3779aneJ

OVERDOSE DEATHS JUMP IN INDIANA

The number of Hoosiers who died from drug overdoses increased 147 
percent from 1999 to 2004, a trend driven by the growing abuse of 
prescription medications, according to a new study.

The problem, experts say, has shown no sign of abating and is 
expected to worsen.

"This is the new major drug epidemic for the next generation," said 
Eric R. Wright, director of the IU Center for Health Policy and one 
of the authors of the study "Fatal Drug Overdoses: A Growing Concern 
in Indiana."

The problem, Wright said, is believed to be most serious among young 
adults and adolescents who take part in "pharm" parties, where they 
bring pills, throw them into a bowl and then indiscriminately grab a 
handful to take.

Overdose deaths jumped from an average of fewer than one a day in 
Indiana in 1999 to nearly two a day in 2004, an increase of 147 
percent. That's more than 2 1/2 times the national increase; the 
number of overdose deaths in the U.S. increased 57 percent during the 
same period.

National studies found no significant increases in the use of illegal 
drugs or binge drinking in Indiana during the period covered by the IU study.

Misuse of prescription drugs is the fourth-most serious substance 
abuse problem in Indiana, Wright said, and is likely to overtake 
marijuana in the next five years to become third behind alcohol and tobacco.

Wright's report calls for a greater effort to educate the public and 
medical community about the dangers of legal as well as illegal drugs.

The statistics hit home in Greencastle in December when a popular 
high school senior, 17-year-old Dietrich Jackson, died after 
ingesting several prescription drugs at a house party after a basketball game.

Putnam County Prosecutor Tim Bookwalter said authorities were caught 
off guard by the death.

"Meth had been such a big issue, we had not recognized this (as a 
problem)," Bookwalter said. "Prescription drug abuse came on the 
horizon so quickly, especially among young people."

Bookwalter said the allure and danger of prescription drugs are that 
they can be found in almost every home.

"They (users) don't have to go out and find them from a dealer or pay 
a high price," he said. "And they just don't think of those drugs 
like they do cocaine, heroin or meth. It just doesn't connect with 
them; they don't recognize the danger."

Charity Pankratz, who was raising her grandson, said she worried that 
Jackson might succumb to the temptation of alcohol or marijuana, but 
"prescription drugs didn't even occur to me."

Jackson wore a wristband promoting a drug-free life, which Pankratz 
said gave her a false sense of security.  According to court records, 
Jackson crushed and snorted the anti-anxiety medication Xanax and 
oxymorphone, a powerful painkiller, while drinking beer on the night he died.

"It's too late for Dietrich," Pankratz said, "but if the awareness 
created by his death stops one kid from doing something, then that 
will be a positive."

Indiana's rate of drug overdose deaths was substantially lower than 
the national rate in 1999 but almost had caught up by 2004, the last 
year for which national data are available, the IU report revealed. 
Indiana deaths increased again in 2005, matching the 2004 U.S. rate 
of one death per 10,000 residents for the first time.

 From 1999 to 2005, 2,958 fatal overdoses were reported in Indiana, 
including 924 in Marion and its eight surrounding counties. Marion 
County accounted for 572 of those deaths.

The problem is not confined to urban areas, Wright said. The death 
rate is highest in some rural areas such as Henry, Scott and Starke counties.

Wright said some users may be turning to prescription drugs as a 
substitute for harder-to-find illegal drugs.

Most prescription drug abuse takes place in social settings and is 
driven by fads within local communities, he said. That's why there 
are pockets in Indiana where the problem is worse than in other areas.

The most-abused prescription drugs are opiates and stimulants.

Availability is a factor in the abuse of these drugs because many 
people get the medications from family or friends. Oxycodone 
prescriptions in Indiana, for example, nearly doubled, from 29 
million dosage units in 2002 to 54 million in 2007, providing many 
more opportunities for users to snatch pills from a medicine cabinet.

Prescription drug abuse is a complicated problem with no clear or 
easy answers, Wright said.

"We are a pill-driven society," he said. "Drugs are heavily marketed, 
and that conveys an image of safeness."

Although programs have been in place for years to address the problem 
of abuse, Wright said, "it is clear, given the data, that what we're 
doing is not enough."

IU's report suggests recruiting physicians and pharmacists to help 
find solutions.

"We have to figure out how to get people the medications they need, 
but without having large supplies when they don't need them," Wright said.

Helping patients manage pain is one of the toughest issues physicians 
deal with, said Dr. Vidya Kora, a general internist who is immediate 
past president of the Indiana State Medical Association and the 
LaPorte County coroner.

"Pain is subjective, and there is no test to quantify it," he said. 
"There is a problem if we undertreat pain, and there is a problem if 
we overtreat pain. It's a very delicate balance."

The state medical association held a seminar for doctors last year 
that addressed the prescription of controlled substances, Kora said. 
The session covered issues related to patient evaluations, 
documentation and compliance with dispensing regulations.

Kora also believes expansion of a program operated by the state Board 
of Pharmacy holds some promise for reducing the number of patients 
who "doctor shop," or try to get drugs from multiple physicians.

The INSPECT program initiated in 1994 includes a database of drug 
prescriptions but was available only to law enforcement until 2007. 
Now, doctors and pharmacists also can check on patients when they 
suspect prescription abuses.

The abuse of prescription drugs has been recently identified by the 
Governor's Commission for a Drug-Free Indiana as a major problem. The 
commission last year distributed about $5.5 million to counties for 
education, treatment and enforcement projects.

Such help is critical because an addiction to prescription drugs is 
hard to fight, said David Stanley, 55, Indianapolis, a recovering 
prescription drug addict who said he has been clean for 33 months.

Stanley said his habit began after he was given legitimate 
prescriptions after back surgeries in the 1980s. Although his medical 
need for the pills passed, he said, his psychological dependency grew.

"It doesn't matter if it's alcohol, cocaine, heroin or pills," he 
said. "The one thing people need to know is that they all lead you to 
the same places: jails, institutions or death." 
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