More people in Arizona died from drug overdoses than from car accidents in 2010, according to a report Monday that said the state had the sixth-highest overdose rate in the nation that year.
And Arizona was one of nine states with the fewest “indicators of promising strategies” to cut down on prescription drug abuse, said the report by the Trust for America’s Health.
The report, “Prescription Drug Abuse: Strategies to Stop the Epidemic,” said Arizona had 17.5 overdose deaths per 100,000 people in 2010, but had adopted only four of 10 possible strategies to improve that statistic. The report measured both prescription and illicit drug deaths.
“It’s at epidemic proportions,” said Tomi St. Mars, a registered nurse who runs the Arizona Department of Health Services‘ Office of Injury Prevention.
St. Mars said researchers “don’t have a lot of evidence about what works and what doesn’t” with prescription drug abuse, a problem she said is “huge” in Arizona. But some of the strategies cited in the report – such as stricter ID requirements before dispensing drugs or a “good Samaritan” law to protect those seeking help for an overdose – could be effective in Arizona, she said.
Jeff Levi, executive director of the Trust for America’s Health, said that unlike Arizona, most of the states with the highest overdose death rates had enacted most or all of the 10 strategies recommended in the report.
He said most of those state actions were “relatively new,” and the fact that policies were in place “didn’t necessarily indicate the degree to which they are implemented.”
“But, it’s a good sign that these states with the highest rates have started to put these policies in place,” Levi said.
Andrea Gielen, director of the Johns Hopkins Center for Injury Research and Policy, said prescription drug overdose “is a problem that’s come on the scene quickly” and researchers still have questions about the rise in prescription drug abuse. One thing they know, she said, is that where prescriptions are more common, abuse tends to be more prevalent.
Arizona ranked 13th in the U.S. for legal sales of opioid pain relievers and fourth for nonmedical use of prescription drugs by people 12 and older in 2010-2011, according to the trust’s report.
St. Mars said her data shows that poisoning – which includes drug and alcohol overdoses – became the leading cause of injury-related death in Arizona in 2007. It reached an all-time high of 27 percent in 2009 and accounted for one injury-related death in four in 2011, she said.
The data also showed that overdoses of the prescription drugs oxycodone and hydrocodone were second only to alcohol as the cause of poisoning deaths in Arizona in 2010, though it is “not uncommon” that overdoses come from a combination of substances.
St. Mars said her office has worked with hospital emergency rooms statewide to create guidelines to help cut down on prescription drug abuse. In two weeks, she said, the office will begin working with clinicians to develop similar guidelines for community-based settings.
Some efforts are not reflected in Monday’s report, St. Mars said, such as the Arizona Prescription Drug Misuse and Abuse Initiative.
The initiative has collected more than 5,000 pounds of unused medication through drop boxes and take-back events in Yavapai, Pinal, Graham and Greenlee counties and was named an outstanding program in 2013 by the National Criminal Justice Association.
The pilot program, with no government funding, has been successful “primarily because of the involvement of citizens,” said George Diaz, spokesman for the Arizona Criminal Justice Commission, one of the partners in the effort.
Prescription drug abuse is a complex “crisis” and addressing it at the state level can be difficult, St. Mars said, but the county-level program is showing promise because it has citizen “coalitions that are awake, aware and moving this forward.”
“By far this now kills more Arizonans and U.S. folks than motor-vehicle crashes,” St. Mars said of prescription abuse. “And I can’t put a seatbelt on it.”
A Trust for America’s Health report outlined 10 strategies for cutting down prescription drug abuse. Arizona was one of nine states that had adopted four strategies or fewer:
Adopted in Arizona:
• Prescription drug monitoring program.
• “Doctor shopping” laws that require patients to give doctors information about prescriptions from other healthcare providers.
• Support for substance-abuse treatment services.
• A requirement that healthcare providers perform a physical exam before prescribing drugs.
Strategies not adopted in Arizona:
• Mandatory use of a prescription-drug monitoring program by prescribers.
• Education for healthcare providers who prescribe pain medication.
• “Good Samaritan” laws that provide protection for those seeking treatment for themselves or others during an overdose.
• Rescue-drug laws that expand who can obtain and administer naloxone, a prescription drug that can counteract an overdose.
• Requirements that a pharmacist check a customer’s ID before dispensing drugs to them.
• “Lock-in” programs that would require some Medicaid recipients to use a single prescriber and pharmacy in an effort to head off abuse.