January 1st, 2014

Prescription drug deaths high in R.I.

Along with the increase of prescription drug use in the U.S., the number of drug-related deaths has risen sharply across the country with some states seeing rates quadruple since 1999.

Here in New England, states are above average in preventing deaths – except for Rhode Island which comes in at number 13 overall.

According to a recent report by the non-profit organization Trust for America’s Health (TFAH), Rhode Island sees 15.5 deaths per 100,000 people, up from 5.5 in 1999. The State’s Medical Examiner’s Office reports an average of four deaths per week.

In comparison, the next closest in ratings is New Hampshire, at 26th, followed by Massachusetts (32), Maine (38), Connecticut (39), and Vermont (42). While rankings like these can be disingenuous because numbers can still be very close, in this case, the difference between 13 and 26 is more significant. New Hampshire’s rate of deaths is at 11.4/100,000.

“What jumps out for me is that any time you have these public health type of categories, there is a highest and lowest by order of magnitude but the difference is within one point,” says Richard Hamburg, deputy director for TFAH. “In this area there is a more dramatic difference.”

In a new trend, the majority of overdose fatalities involve the use of prescription drugs. As Hamburg pointed out, an increase in the number of prescriptions issued for opioids could be a factor.

“Overall, there has been a huge increase in legal prescriptions of pain killers and opioids,” says Hamburg, “and when we are seeing the number of prescriptions go up by as much as four times in the past decade, it is not too shocking that misuse is going up if not proportionately, not too dissimilarly.”

According to the report, there are more deaths across the country from prescription drug misuse than from heroin and cocaine combined. This trend has also been a factor in Rhode Island’s high rates, says Craig Stenning, director of the Rhode Island Department of Behavioral Healthcare, Developmental Disabilities and Hospitals.

“Traditionally, Rhode Island and other southern New England states have had high incidence of opioid abuse,” says Stenning. “Prior to the prescription drug abuse epidemic, the opioid commonly abused was heroin.”

The good news is that the TFAH report also commended R.I. for having eight of 10 strategies in place that have been shown to reduce drug abuse. In the past year, the state increased access to naloxone, a medication that can be used to reverse overdose from opioids. The state has also expanded its Good Samaritan law to provide immunity to anyone calling in an overdose if illicit drugs are involved and the Department of Health launched a prescription monitoring program in 2012.

“Unlike our neighboring states, whose opioid abuse rates have been consistently similar to ours, Rhode Island did not have a ‘user friendly’ Prescription Drug Monitoring Program (PDMP) until this past year,” says Stenning, “and data is already showing an impact of the PDMP on reducing overdose deaths related to prescription drugs. Rhode Island also has only recently adopted laws which increase the availability of naloxone, the overdose rescue drug.”

The state’s Department of Health is seeing success with the new programs although the issue continues to be a major concern.

“The number of prescription drug overdose deaths appears to be falling, a trend that began in the spring,” says Michael Fine, M.D., director of the Department of Health. “But total overdose deaths continue to increase. I think the progress is due to the prescription monitoring program and the department’s efforts, led by James McDonald, M.D. (chief administrative officer of the Board of Medical Licensure and Discipline), to alert the prescripting community to safe prescribing.”

By Catherine Robertson Souter

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