Opioid abuse spreads; Montana teen abuse numbers up

The problem of addiction has stretched across America for decades. Whether in rural communities, city centers, or the suburbs, addiction hits hard.

Now, the problem has become even more complicated. A commonplace addiction to opioids, a class of prescription drugs that includes morphine, tramadol, oxycodone, methadone, fentanyl, codeine and a cocktail mix of many more has attracted the abuse of these medicines.

The number of opioid drug addicts is continuing to rise across the country, including Montana, which is ranked third in the nation for teen abuse of prescription pain relievers. Between 2011 and 2013, prescription drug overdoses in Montana were responsible for at least 369 deaths and more than 7,200 hospital inpatient admissions and emergency department cases, according to the Montana Department of Health and Human Services’ Office of Epidemiology and Scientific Support.

These poppy-based drugs are nothing new to the American culture. They are one of the world’s oldest numbing painkillers dating as far back as the 1500s when Laudanum was used as an analgesic.

Heroin, which is an opium derivative, was actually introduced into the U.S. in 1874 to combat the country’s overwhelming addiction to opium. Opium had been introduced approximately 30 years earlier by Chinese immigrants who had come to the country to work on the railroads.

Heroin was not considered dangerous back then, and was actually sold in the U.S. to treat mild conditions such as menstrual pain. But in the 1920s, Congress banned the drug because of its highly addictive qualities. Fast forward to today, where nearly 20,000 Americans fatally overdose on opioid prescription drugs in 2014 alone.

The resurgence of opioid addiction goes back to 1996 with the sale of a new drug on the market called OxyContin, which is a time-released opioid. It was promoted as safe and highly effective, and was stronger than morphine. In 2007 the company that promoted and sold OxyContin, Purdue Pharma, was charged and found guilty of misleading regulators, doctors, and patients about the drugs’ addictive qualities. The company was ordered to pay $600 million in connection with illegal promotion and misrepresentation of the drug.

 In 2010, Purdue reformulated the drug in a way that makes it harder to abuse. In that form, it is on the market and patented until 2025. Meanwhile, the FDA banned the production of generic, cheaper versions of the drug in 2013 in order to stem the tide of abuse. Unfortunately, this has resulted in many addicts turning back to heroin, which is much cheaper than OxyContin. Studies have also shown that four out of five heroin addicts were hooked on opioids first.

Steps are being taken to help deal with the opioid problem in Montana, such as physicians writing fewer prescriptions for opioid medications. Some states, including Montana, have set up databases that track patients who receive prescriptions called the Prescription Monitoring Program. This allows physicians to improve patient safety, and they can check to see if patients are getting pills from multiple locations.

Other steps being taken are to increase public awareness of the dangers associated with opioids. In 2013, the Montana Attorney General’s Office initiated a public awareness campaign, the Invisible Epidemic, to address prescription drug misuse. This campaign includes medication “Take-back” days where unused and/or expired medication is collected and disposed of properly, keeping the drugs out of the hands of abusers.

Mineral Community Hospital CEO Ron Gleason said that the hospital has not seen a marked increase in the number of opioid overdose emergencies so far. However, steps are being taken to help keep the epidemic at bay in the county, including the installation of a Lock Box at the Mineral County Courthouse in Superior.

These boxes give people a place where they can take their drugs to be disposed at any time. They are typically installed at law enforcement departments, pharmacies and medical facilities. According to Mineral County Prevention Specialist, Stephanie Quick, 60 percent of teens who abuse prescription drugs get access to them from family members or from friends’ medicine cabinets.

Quick and Kaelyn Kelly, who is an Rx Drug Abuse Prevention Coordinator with the Attorney General’s Office, recently held a kickoff campaign in Superior to help bring awareness to this growing problem.

Another step individuals can take to properly dispose of unused medication is to purchase special postage-paid envelopes that are available at some pharmacies, for example CVS in Missoula. They cost $4.87 each and people put unwanted drugs into the envelopes and drop them off at the post office.

Kelly also said that drugs can be placed in a sealed container, like a plastic margarine bowl, then mixed with vinegar, coffee grounds, cat litter, or other substances to make the drugs ineffective. The container can then be safely disposed of in the garbage. To make this solution even more effective, first put the pills into a plastic bag and crush them with a hammer or a rolling pin before mixing them with coffee grounds or other substances.

Kelly stated that “many people equate prescription painkillers the same as Tylenol or other over-the-counter pain relievers and nothing could be further from the truth. These narcotics can be fatal.”