Stop painkillers from being killers

The Observer editorial board

Opioid painkillers such as OxyContin can reduce pain but are dangerously addictive.
Opioid painkillers such as OxyContin can reduce pain but are dangerously addictive. AP File Photo

While the nation’s attention vacillates between Donald Trump and bathroom stalls, thousands of people are dying from overdosing on drugs prescribed to them by their doctors. And North Carolina is one of the epicenters of the epidemic.

Authorities are investigating whether pop star Prince was addicted to prescription painkillers and whether any addiction contributed to his untimely death last month. If so, he would be only the most public recent example of a phenomenon that is growing rapidly each year.

The Centers for Disease Control and Prevention says that nearly 29,000 Americans died from abusing opioids, which include prescription painkillers and heroin, in 2014. The death rate from opioid abuse tripled from 2000 to 2014. Drug overdose is now the leading cause of accidental death in the United States.

North Carolina has felt the pain about as intensely as any state, with more than 1,300 dying of overdoses in 2014 alone. As the Observer’s Fred Clasen-Kelly has reported, some N.C. counties have drug overdose fatality rates that are among the nation’s highest. In 2002, Cherokee was the only N.C. county with an overdose death rate of more than 20 per 100,000 people, Kelly reported. By 2014, 27 N.C. counties had rates that high.

A report that year from the N.C. Program Evaluation Division, the legislature’s research arm, found death rates were higher in places where doctors wrote the most prescriptions for opioid drugs, and experts say growing addiction is driving the trend. A CDC study found that only about 15 percent of those most likely to overdose bought their opioids from a drug dealer.

North Carolina’s rate of fatal drug overdoses has spiked 75 percent since 2002. “This is now an unequivocal public health crisis,” Dr. Scott Kirby, chief medical officer for the N.C. Medical Board, told Kelly.

The U.S. House passed more than a dozen bills last week aimed at slowing the crisis. While they include helpful provisions, it appears they do not include the funding required to dramatically fight the problem.

In North Carolina, the Senate this week is expected to consider a bill to make overdose reversal drugs more easily available to the public. More naloxone hydrochloride could cut fatal overdoses in half, state health director Randall Williams said.

That’s a fine move but, as Williams said, it merely treats the symptom. In North Carolina and nationally, public campaigns need to make doctors and patients alike more aware of opioid painkillers’ danger so they are not overprescribed.

Doctors also must better use technology to ensure patients are not shopping around to stockpile painkillers. Doctors can use a database known as the Controlled Substance Reporting System to check on all narcotics that have been issued to a patient. Meanwhile, the N.C. Medical Board needs to follow through with its promise to elevate this issue as a priority, in part by more closely monitoring doctors who prescribe the most opioids and whose patients overdose.

More people die of drug overdose than in car accidents. It’s past time we lent the problem similar attention.