NEW YORK (AP) —
Sales of the nation's two most popular prescription painkillers have
exploded in new parts of the country, an Associated Press analysis
shows, worrying experts who say the push to relieve patients' suffering
is spawning an addiction epidemic.
From New York's
Staten Island to Santa Fe, N.M., Drug Enforcement Administration
figures show dramatic rises between 2000 and 2010 in the distribution of
oxycodone, the key ingredient in OxyContin, Percocet and Percodan. Some places saw sales increase sixteenfold.
Meanwhile, the distribution of hydrocodone,
the key ingredient in Vicodin, Norco and Lortab, is rising in
Appalachia, the original epicenter of the painkiller epidemic, as well
as in the Midwest.
The increases have coincided with a wave of overdose deaths, pharmacy robberies and other problems in New Mexico, Nevada, Utah, Florida
and other states. Opioid pain relievers, the category that includes
oxycodone and hydrocodone, caused 14,800 overdose deaths in 2008 alone,
and the death toll is rising, the Centers for Disease Control and
Prevention says.
Nationwide,
pharmacies received and ultimately dispensed the equivalent of 69 tons
of pure oxycodone and 42 tons of pure hydrocodone in 2010, the last year
for which statistics are available. That's enough to give 40 5-mg
Percocets and 24 5-mg Vicodins to every person in the United States. The
DEA data
records shipments from distributors to pharmacies, hospitals,
practitioners and teaching institutions. The drugs are eventually
dispensed and sold to patients, but the DEA does not keep track of how
much individual patients receive.
The increase is partly due to the aging U.S. population with pain issues and a greater willingness by doctors to treat pain, said Gregory Bunt, medical director at New York's Daytop Village chain of drug treatment clinics.
Sales are also being driven by addiction, as users become physically dependent on painkillers and begin "doctor shopping" to keep the prescriptions coming, he said.
"Prescription
medications can provide enormous health and quality-of-life benefits to
patients," Gil Kerlikowske, the U.S. drug czar, told Congress in March.
"However, we all now recognize that these drugs can be just as dangerous
and deadly as illicit substances when misused or abused."
Opioids
like hydrocodone and oxycodone can release intense feelings of
well-being. Some abusers swallow the pills; others crush them, then
smoke, snort or inject the powder.
Unlike
most street drugs, the problem has its roots in two disparate parts of
the country — Appalachia and affluent suburbs, said Pete Jackson,
president of Advocates for the Reform of Prescription Opioids.
"Now it's spreading from those two poles," Jackson said.
The
AP analysis used drug data collected quarterly by the DEA's Automation
of Reports and Consolidated Orders System. The DEA tracks shipments sent
from distributors to pharmacies, hospitals, practitioners and teaching
institutions and then compiles the data using three-digit ZIP codes.
Every ZIP code starting with 100-, for example, is lumped together into
one figure.
The AP combined this data with census figures to determine effective sales per capita.
A
few ZIP codes that include military bases or Veterans Affairs hospitals
have seen large increases in painkiller use because of soldier patients
injured in the Middle East, law enforcement officials say. In addition,
small areas around St. Louis, Indianapolis, Las Vegas and Newark, N.J.,
have seen their totals affected because mail-order pharmacies have
shipping centers there, said Carmen Catizone, executive director of the
National Association of Boards of Pharmacy.
Many of the sales trends stretch across bigger areas.
In
2000, oxycodone sales were centered in coal-mining areas of West
Virginia and eastern Kentucky — places with high concentrations of
people with back problems and other chronic pain.
But
by 2010, the strongest oxycodone sales had overtaken most of Tennessee
and Kentucky, stretching as far north as Columbus, Ohio and as far south
as Macon, Ga.
Per-capita oxycodone sales increased five- or six-fold in most of Tennessee during the decade.
"We've
got a problem. We've got to get a handle on it," said Tommy Farmer, a
counterdrug official with the Tennessee Bureau of Investigation.
Many
buyers began crossing into Tennessee to fill prescriptions after border
states began strengthening computer systems meant to monitor drug
sales, Farmer said.
In 2006,
only 20 states had prescription drug monitoring programs aimed at
tracking patients. Now 40 do, but many aren't linked together, so
abusers can simply go to another state when they're flagged in one
state's system. There is no federal monitoring of prescription drugs at
the patient level.
In Florida,
the AP analysis underscores the difficulty of the state's decade-long
battle against "pill mills," unscrupulous doctors who churn out dozens
of prescriptions a day.
In 2000, Florida's oxycodone sales were centered around West Palm Beach. By 2010, oxycodone was flowing to nearly every part of the state.
While
still not as high as in Appalachia or Florida, oxycodone sales also
increased dramatically in New York City and its suburbs. The borough of
Staten Island saw sales leap 1,200 percent.
No comments:
Post a Comment