RALEIGH Deaths from prescription drug overdoses are growing at an alarming rate in North Carolina and could eventually overtake motor vehicle accidents as the most common cause of accidental fatalities, according to a report released this week by the N.C. Child Fatality Task Force.
The increase in deaths from accidental overdose are most pronounced among adults, but the trend is also evident among teens, raising alarm bells for members of the task force, said its director, Elizabeth Hudgins.
“From 2000 to 2004, overdose deaths of children and teens averaged nine per year in North Carolina,” Hudgins said. “During the next four years, the average was 15. That’s certainly heading in the wrong direction.”
The task force issued its 2013 annual report Thursday, noting that child death rates overall stand at their lowest on record, down 46 percent over the past 21 years.
“While most causes of child death are declining, deaths due to poisoning are increasing,” said the report. “This trend is driven by teen misuse of prescription drugs. It is consistent with national trends across all age groups; indeed abuse of these controlled substances is surpassing motor vehicle crashes as the leading cause of injury death in the United States.”
Most notably, deaths due to motor vehicle accidents in North Carolina have declined steadily over the past decade, from 1,573 in 2001 to 1,210 in 2011. During that same time, deaths due to unintentional poisoning – 92 percent of which are drug overdoses – have grown from 437 to 1,140 statewide.
The uptick in overdose deaths roughly coincides with a shift in the American Medical Society’s philosophy of pain management in about 2009, said Scott Proescholdbell, investigator of the Violent Death Reporting System for the state Division of Public Health.
“There has since been a greater emphasis on relieving pain for patients,” Proescholdbell said. “The pendulum swung from not treating pain to treating it with medication.”
Almost all of the overdose deaths recorded involved opiate-derived drugs such as hydrocodone and oxycodone, commonly given for pain relief, said Mike Lancaster, behavior health program director for N.C. Community Care, a statewide network of physicians providing care to low-income residents.
“People may think because they’re taking a prescription drug it’s safer, but it doesn’t take that much to cause respiratory depression and death,” Lancaster said.
Sometimes teens have access to the drugs for legitimate reasons, such as when their wisdom teeth are removed. Others are using drugs stored in the medicine cabinets of family and friends.
“One classic case was a healthy, 17-year-old quarterback in Burlington who died after taking methadone that belonged to someone else,” Lancaster said. “He may have thought: My grandmother takes this medicine. How can it possible hurt me?”
But patients often build up a tolerance to the medication, requiring larger and larger doses to relieve pain. “It could have been a safe dose for his grandmother, but a massive dose for him,” Lancaster said.
Mixing pain medication with alcohol or benzodiazepine anti-anxiety medications, such as Xanax or Valium, also can result in death, he said.
To address the problem, the task force made several recommendations, including reducing the amount of time it takes to have filled prescriptions appear on the state’s Controlled Substances Reporting System. The lag time is now seven days.
“The whole community has to understand that if you’re taking pain meds, make sure they are safe and secure,” Lancaster said.
Fred Brason founded Project Lazarus in Wilkes County to do just that after he became aware that his community had one of the highest rates of overdoses from prescription medications in the country.
“Many times in the past, medications were freely shared among family and friends,” Brason says. “But with these new medications, we really can’t do that. They have addictive properties, and people wind up in trouble. People are finding and using it that would never touch heroin or cocaine.”
The agency provides technical assistance to community groups and medical offices to find ways of preventing drug overdoses while still treating patients with chronic pain.
“It’s the same message for everybody; we include schools and pediatricians in every community,” he said. “Nobody can be left out of the mix. It’s affecting all age groups.”
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