The Denver Post
Deaths linked to prescription opioid use have doubled in 10 years in Colorado, and the steep increases in both legal use and dangerous abuse of painkillers are forcing the medical community to rethink the way it treats chronic pain.
Painkiller prescriptions written by the top 10 Medicaid prescribers for one popular drug, Roxicodone, shot up 46 percent last year, according to state records. Denver's Office of Drug Strategy found that prescriptions filled for oxycodone rose 58 percent from 2007 to 2011.
Nonmedical use of painkillers in Colorado is 19 percent higher than the national average, according to the Centers for Disease Control and Prevention. To illustrate the "epidemic" nature of opioid abuse, the CDC said
h of the painkillers were sold in 2010 to medicate every American adult with a typical 5-milligram dose of hydrocodone every four hours for a month."People think, 'It's a pharmaceutical, it's pure, it's good for me.' That lends itself to a casualness about the use of it," said Art Schut, deputy director of the Arapahoe House addiction-treatment center in Thornton. Patients learn too late that opioids are severely addictive, in part because of their ability to both block pain and induce euphoria.
The number of Arapahoe clients coming in for opioid dependency or addiction has doubled in four years, Schut said. Those kinds of numbers have raised questions about a pain-care philosophy that began more than a decade ago. Doctors say using opioid-based pills to treat lingering pain helped millions of people. But they increasingly acknowledge mounting abuse requires a safety overhaul of their practices.
State epidemiologists say opioid-related deaths in Colorado rose from 182 in 2000 to 421 in 2009, before retreating some. The 2011 count is at least 362 deaths, although the year's review of death certificates is not yet complete.
Opioids for patients in real need "are far and away the most effective
Kaiser moving aggressively
Kaiser Permanente in Colorado is among those moving aggressively to reform painkiller prescribing and dispensing.
The nonprofit HMO launched a review in January of every painkiller patient in its database. The review spit out lists of patients with complicating risk factors, such as other prescriptions for anxiety drugs or a family history of dependence. The system, covering 535,000 patients and 900 doctors, told each doctor to meet with those on the list within 60 days.