Top 10 prescriptions
Top 10 medication prescriptions filled by Kansas pharmacies in 2011, followed by the condition they treat:
• Vicodin with aspirin: 1.5 million, pain
• Ambien: 519,542, insomnia
• Xanax: 494,555, anxiety
• Ultram: 380,656, pain
• Percocet with aspirin: 329,585, pain
• Klonopin: 265,197, pain and seizures
• Ativan: 254,707, anxiety
• Adderall: 209,047, ADHD
• Percocet: 171,545, pain
• Ritalin: 158,625, ADHD
On a daily basis, people in Lawrence engage in an underground economy of selling and buying prescription pain medications, said a Douglas County mother of two.
“Dispersed all over town,” said the woman, who began abusing prescription pain medications like Oxycontin over the past couple of years. “It’s a huge epidemic.”
She did it all while raising two children and living a “regular life.”
“You would have no idea,” said the woman, who asked to remain anonymous. She said she nearly died after an overdose of pain medications in September. Sometimes to avoid the withdrawal effects, the woman would pay up to $100 for one pill.
The abuse of such prescription pain medications — opioids derived from the same source as heroin — is increasing across the state, according to data obtained from the Kansas State Board of Pharmacy.
Four of the top 10 medications prescribed since 2010 in Kansas were pain medications, such as Vicodin and Percocet. Physicians prescribed more than 44 million pills of hydrocodone, the generic name for Vicodin, last year alone. All four of those medications have seen increases since 2010.
Deaths from opioid overdoses have increased fourfold since 1999, with 97 such deaths recorded in Kansas by hospitals in 2011.
The over-prescribing of such medications is creating addiction problems for patients across the country, said Richard Chapman, director of the University of Utah’s Pain Medication Research Center.
“People are prescribing opioids like crazy,” Chapman said. “It’s all over the country.”
Chapman said the rise in the past decade of prescriptions for pain medications started as a well-intentioned effort by doctors who saw the pain-relief benefits of such drugs on terminally ill cancer patients.
Doctors then began prescribing opioids for everything from arthritis to back pain.
A main issue with the increase in prescribing opioids for pain is a lack of controlled studies on their effects in non-cancer patients, Chapman said.
The increased use has caused a “host of complications we’d never imagine,” including decreased energy, and ironically an increased sensitivity to pain, Chapman said.
Jeff Sigler, a Lawrence pharmacist, said that in addition to a willingness by physicians to prescribe opioid medications for pain, societal shifts in how Americans tolerate pain has played a role in an increased use of opioids. Instead of toughing it out, people go to the doctor.
“Our society is less tolerant to pain than we used to be,” Sigler said.
And people are more sedentary, which can exacerbate back pain problems, one of the major ailments reported by those prescribed pain medications, Sigler said.
‘It’s a game’
Jan Campbell, an addictions psychiatrist at the Kansas University Medical Center, said common sense measures and guidelines for physicians can reduce opioid abuse. For instance, doctors who prescribe such medications need to thoroughly evaluate patients, requiring documentation of pain-related ailments and history. And doctors need to inform patients about the abuse potential of opioids and how to get help if they notice signs of addiction.
Several states, such as Florida, have enacted measures to prevent overprescribing, including requiring a blood test of patients so doctors can see whether a patient already has opioids in his or her system.
While those measures could cut down the number of people who “doctor shop” for opioids, it wouldn’t prevent all forms of abuse.
The Douglas County woman who struggled with opioid addiction bought her opioids from a man whose mother was legitimately prescribed Oxycontin for terminal cancer. The man’s mother would keep enough for her own supply and make thousands of dollars every month selling off hundreds of other pills.
When the woman’s supplier was out of the medications, getting them from another source was no problem.
“It’s a game,” she said, detailing the network of local people actively engaged daily in selling and using prescription opioids.
Her abuse and addiction just kept ratcheting up, and she needed more and more of the drugs to hold back withdrawal effects.
“It really took over,” she said.
She lost her job, her home and her car. As she approached rock bottom, she began scraping off — then shooting intravenously — the residue from a pain medication patch, which when worn slowly releases the drug into the body. When injected, the effects are quicker and more potent.
In September, she was rushed to a hospital after she stopped breathing while using opioids.
“I was dead,” said the woman, who required resuscitation. She remembers little of her weeks-long hospital stay or the overdose. “My body was done.”
Fear of losing custody of her two children provided enough incentive to get clean, said the woman, who hasn’t used opioids in eight months.
She’s slowly rebuilding the regular life she once had, hoping to put her time as an opioid addict behind here.
“It’s not easy,” she said.