Pennsylvania is near the top of the national statistics for drug overdose deaths, but neighboring states West Virginia and Ohio are being hit even worse, according to a report released last week.
Use of prescription drugs and heroin is fueling the problem, and the number of deaths from drug overdoses now surpasses car accident-related deaths in Pennsylvania and 35 other states.
“We are really one of the epicenters in the country,” said Dr. Neil Capretto, medical director at Gateway Rehabilitation Center, a private nonprofit with locations across Pennsylvania.
The report, published by the Trust for America’s Health and the Robert Wood Johnson Foundation, breaks down all injury-related deaths — including automobile incidents, drownings, falls and fires — by state. Pennsylvania fell in the middle of the pack for all injury-related deaths, coming in at No. 23, but its drug overdose deaths were significantly above average, at No. 9. Pennsylvania was also one of seven states to score a relatively low 4 out of 10 on key indicators that states can take to prevent those deaths.
Still, the epidemic is hitting Ohio and West Virginia with even more force. Ohio had the eighth highest drug overdose death rate, and West Virginia had the highest, with 32.1 of every 100,000 residents dying from drug overdose in 2013, the last year for which the Centers for Disease Control and Prevention has data. Out of a relatively small population of 1.85 million in West Virginia, 570 deaths from drug overdoses were recorded in that year. In Pennsylvania, with a much larger population, the number of overdose deaths was 2,426.
Prescription drugs accounted for more than half of the roughly 44,000 overdose deaths in the U.S. in 2013, the report found. Professionals started seeing increases in drug overdose deaths in the late ’90s. From 1997-2005 nationally, prescriptions increased 700 percent for OxyContin, 300 percent for hydrocodone and 1,000 percent for methadone, said Dr. Capretto, who was not involved in the report. Though deaths from prescription drug overdoses peaked nationally around 2012, heroin overdose deaths have increased since then, leading to an overall uptick in deaths from drug overdoses.
Because the demographics in southwestern Pennsylvania include more elderly people and blue collar workers who may be injured on the job, the numbers are high here, he said.
The number of deaths by drug overdose first surpassed the number of deaths in car accidents four years ago, and doubled in between 1999 and 2013, said Jeffrey Levi, executive director of the Trust for America’s Health, and one of the authors of the report.
In Allegheny County, there were roughly 100 drug overdoses in 2000. But by 2014, that number had jumped to 306, and it only seems to be increasing, said Karen Hacker, director of the Allegheny County Health Department. According to data from the Pennsylvania State Coroners Association, that puts Allegheny County behind only Philadelphia County in total overdose deathsm, and makes it 1 in only 5 counties with more than 100 deaths.
“The prescription drug epidemic is really troubling,” said Corinne Peek-Asa, associate dean for research at the College of Public Health at the University of Iowa, and the past president of the Society for Advancement of Violence and Injury Research. “More than 2 million Americans use prescription drugs, and it’s fueling a rise in heroin use.”
That’s because, like prescription pain medications, heroin is an opioid — a substance that reduces the intensity of pain signals in the body. When a physician stops prescribing opioids or those drugs become too expensive, a patient may switch to heroin, which is relatively cheap and easy to obtain.
Physicians, policy makers and the pharmaceutical industry have taken steps to address the epidemic, but it’s not nearly enough, said Abraham Kabazie, director of the Institute for Pain Medicine at West Penn Hospital.
Pennsylvania’s prescription drug monitoring program, for instance — a statewide database that tracks patient prescriptions — is accessible only to the State Attorney General’s Office. Unlike in 25 other states, where doctors can access the data and the program is mandatory, physicians in Pennsylvania have little idea if their patient is “doctor shopping” — using multiple doctors to up their prescription — or requesting more medications before they’ve run out.
Such monitoring programs can have a huge impact, said Dr. Capretto. Research has found that 42 percent of the time, access to prescription data changes the amount that doctors prescribe.
Most of the time, they decrease a prescription or discontinue it. But sometimes, he said, doctors find that their suspicions about a certain patient were unfounded, and they can go back to treating their patients effectively.
Hannah Schwarz: hschwarz@post-gazette.com, 412-263-3772 or on Twitter @hannahrschwarz.
Correction, posted June 23, 2015: A previous version of this story omitted the fact that physicians will soon have access to prescription drug monitoring data. It also made reference to bills having failed in the legislature during the past several years. A bill did pass in 2014, but funding has not been allocated to have it take effect, and the program is not mandatory.