According to Oklahoma Bureau of Narcotics and Dangerous Drugs Control, a record number of Oklahomans died from drug overdoses in 2016, and for the first time in years, methamphetamine was the single biggest killer, preliminary data shows.
952 people died from overdoses, and the number is likely to rise as pending autopsies are finalized. That’s an average of 18 Oklahomans a week dying from overdoses. The total overdose deaths are well above the 862 recorded in 2015 and the previous record of 870 in 2014.
According to the Medical Examiner, meth was involved in 328 of the deaths, climbing steeply from 271 in 2015 and surpassing the total combined deaths involving much-abused opioids hydrocodone and oxycodone. Fatal heroin overdoses continued to surge, with the drug involved in 49 deaths in 2016, up from 31 in 2015. However, opioids remain a potent challenge. As a group, they were involved in more fatal overdoses than meth last year.
In a report published by the Oklahoma Policy Institute in January 2014, “the majority of unintentional poisoning deaths result from the misuse and abuse of opiates (painkillers), distantly trailed by benzodiazepines (anti-anxiety medications). A fact today is still uncontroverted.
The report went on to say “The clear majority of those who abuse prescription painkillers don’t purchase them from the stereotypical dealer on street corners. Almost one in five (17 percent) of those who used prescription painkillers non-medically were prescribed by a doctor; 72 percent got the medication from a friend or relative, and 60 percent of those were given the medication for free (eight percent purchased the medication from a friend or relative, and four percent took the medication without asking). Only four percent purchased the painkillers from a dealer…
Data shows “the casualties of drug abuse are not just hard-core addicts who buy bootlegged meth, crack and heroin from street dealers. They’re middle-aged and middle-class Oklahomans who start taking pain pills for bad backs and other injuries, never dreaming they could wind up tumbling down the slippery slope of addiction, or worse yet, dying from an overdose”, says the Oklahoman.
“Oklahoma is an unhealthy state, ranking 44th worst nationwide for our citizens’ health, rank 42nd for poor physical health days, 45th for occupational fatalities (which suggests a similarly high level of occupational injuries), Oklahomans have high rates of physical inactivity. Dental disease, a common source of severe pain, is also very prevalent in Oklahoma. Chronic pain is, in fact, undertreated in the US. In short, there are a lot of reasons in this state to prescribe painkillers. Perhaps the issue is less a need to restrict legitimate access to painkillers but to reduce the need in the first place” in safety and workplace reform.
Darrell Weaver, former Director of the Oklahoma Bureau of Narcotics and Dangerous Drugs, retired in 2015, said “We believe there’s over 100,000 Oklahomans addicted to prescription drugs… We’re not going to arrest our way out of this problem.”
Terri White, commissioner of the state Department of Mental Health and Substance Abuse Services, said one of the factors that led to prescription drug abuse is so-called doctor shopping, in which patients go from one doctor to the next, collecting prescriptions for painkillers. In 2015, a law requires doctors to check the state’s Prescription Monitoring Program database (PMP) before prescribing opioids and benzodiazepines, such as Xanax, to new patients. Also in 2014, a law was passed requiring reclassification of combination opioids, such as Lortab, which includes hydrocodone and acetaminophen, into Schedule II controlled dangerous substances. The law prohibits doctors from writing prescriptions for more than 90 days and phoning them in to pharmacies.
The Oklahoma Healthcare Authority, which pays for medical services, now scourers the PMP data base targeting solo Doctors who practice in medically underserved communities. If the Authority thinks Doctors are prescribing too many opiates, benzodiazepines or other painkillers to any single patient, it will conduct an audit of the medical records. Experience has shown the audit invariably will conclude the Doctor is incompetent and will terminate the Dr.’s contract or recommend the Doctor no longer to be paid for his medical services under Medicare or Medicaid reimbursement.
We applaud the Authority’s vigilance in the use of the database to monitor the frequency with which Doctor’s write prescriptions to their patients. That is a good thing. What is wrong is the Authority should not reach a verdict that the Doctor has mis-prescribed and then have the trial. The solo practitioner is also a stakeholder in providing healthcare. Terminating a Doctor’s contract to provide medical care should be done fairly and with due process.
The few physicians seeing low income families are trusted healthcare providers and have been for generations. Many low-income residents and people of color are in medically underserved areas and face barriers to good health, such as, limited access to healthy food and parks, underfunded schools, and few economic opportunities. The cry by the Authority that the solo practitioners in medically underserved communities are not competent is defied by the fact they have never been a defendant in a mal-practice suit nor subjected to any adverse action.
The Healthcare Authority should be more concerned in maintaining primary health care physicians in place. If encouraging the physicians to get more training because new technology is required, then it should encourage such training. As stakeholders in the healthcare delivery system, the attitude of “me against them” has no place.
The Authority should be as concerned about the medically underserved receiving the continued medical services. Doctors in these areas are relied upon and trusted. It makes no sense to clear them from the community they have served. Particularly is this true, when there is no actual evidence that patients have actually suffered from the improper practice of medicine. The Healthcare Authority should be more aware that proper care in the hands of a trusted caring physician will serve both well.
The Oklahoma Health Care Authority needs a new cure to save solo physicians.
