Everett, Wash.
Published: Friday, November 7, 2008

Experts gather to tackle abuse of prescription narcotics

Snohomish County has not been immune to deaths and overdoses from potent painkillers

By Diana Hefley
Herald Writer

 EVERETT -- A roomful of doctors, pharmacists, nurses and other health care providers were told Thursday that they have a huge part in battling the alarming increase in prescription pain medication abuse.

Nationwide more people are dying from prescription painkiller overdoses and more people are being rushed to emergency rooms for accidental poisoning from opiate drugs such as oxycodone, fentanyl and morphine.

Those deaths are happening in Snohomish County, too, a seminar for health care providers was told Thursday.

More young people are going to their parents' medicine cabinets to get high. Prescription drugs have jumped to the fourth-most-abused controlled substances among Washington middle and high school students, behind alcohol, marijuana and tobacco, according to a recent state survey.

Police and prosecutors in Snohomish County have seen a rise both in pharmacy robberies and burglaries and in prescription frauds and forgeries. Other crimes, such as car thefts and identity theft, spike to help people pay for their addictions.

Meanwhile, health care professionals struggle to balance properly treating patients who live with chronic pain while recognizing the onslaught of those addicted to and abusing prescription pain medications.

Nearly 200 medical professionals gathered Thursday in Everett to discuss prescription opiate abuse as part of a forum sponsored by the Governor's Council on Substance Abuse and the Snohomish County Medical Society.

Snohomish County prosecutor Janice Ellis, chairwoman of council, said the group has been focusing on prescription drug abuse as the emerging drug trend that's facing communities.

"What makes prescription drug abuse unique is that many people, most people, initially access the drug lawfully," she said.

That's why it's critical to bring health care providers into the conversation of combating the problem, Ellis said.

"When we work together it will help us identify where the problems are," she said.

The spike in abuse has arisen out of policy change that came in the mid-1990s when it became legal for doctors to treat chronic, noncancer-related pain with opiates, said Dr. Gary Franklin, medical director for the state Department of Labor and Industries and a research professor at the University of Washington.

Before then, many people believed doctors didn't care about patient pain, said Dr. Randy Moeller with Group Health Cooperative. Medical providers have been aggressively treating pain for about a decade.

"It's opened Pandora's box," Moeller said.

People being treated for neck, back and abdominal pain are overdosing at alarming rates.

"These are not health conditions people should be dying from," said Dr. Jeffrey Thompson, chief medical officer for the Health and Recovery Services Administration for Washington State Medicaid. "I think we need to take a deep breath and ask if this is the best we can do for our clients."

Doctors recognized that they must balance properly treating legitimate chronic pain while remaining aware of the growing number of people abusing prescription drugs. That includes abusers who go from doctor to doctor, seeking prescriptions.

The state is looking to address that problem with a prescription monitoring program that will include a centralized database available to doctors, pharmacists and law enforcement to track potential abuse.

A group of pain specialists also is reconvening to discuss guidelines to doctors about prescribing pain medications to people with chronic pain who aren't responding to increased dosage.

More education for medical providers is necessary, as are more affordable alternative treatments, Thursday's presenters told the audience. There also need to be more prevention programs, as well as more treatment options for those who become addicted to pain medications.

Snohomish County deputy prosecutor Coleen St. Clair talked to the group about prosecuting drug crimes. She said prescription drug abuse is not just affecting the users but also the people who become the victims of crimes being committed to support the abuser's drug habit.

St. Clair told the audience about a young man she recently prosecuted. He had suffered an injury while playing high school football a few years before. He was prescribed pain medication and became addicted. He began committing crimes to pay for his addiction and also began using heroin as a cheaper alternative to oxycontin.

The man was charged with numerous crimes and through cooperation with St. Clair and his defense attorney, was able to enter drug treatment as part of his criminal sentence. He was a star patient at the treatment facility and was granted a furlough shortly before he was expected to graduate the program.

The first day he was out, the young man overdosed on heroin, St. Clair said.

"I don't know what the answer is. It starts small with the medical community, in schools," St. Clair said. "The devastation it wreaks is on all of us."



Reporter Diana Hefley: 425-339-3463 or hefley@heraldnet.com.
© 2009The Daily Herald Co., Everett, WA