Of nearly 612,000 people in the state identified by the Federal Drug Administration as having prescriptions with the potential for misuse, 2,000 are receiving five or more prescriptions a month.
With so many drugs readily available on the streets, the door for potential misuse is left wide open.
“You got a whole gamut of abuse out there,” Director of Pharmacy Programs for Oregon Health Authority Dr. Tom Burns said.
In the last seven years, the nation has seen a dramatic rise in opiate abuse. In Oregon alone, drug treatment admissions for prescription pills and heroin have risen above methamphetamine.
Lincoln County District Attorney Rob Bovett — who is a leading force in the crackdown on meth throughout the state — has turned his attention to the steadily rising trend of prescription pill abuse. A trend he says creates a circle of addiction and, in most cases, leads the abuser to heroin.
In 2011, opiate users accounted for 33.38 percent of drug treatment admissions, exceeding the 27.9 percent admitted for methamphetamine.
“If you would have told me that five or six years ago, I would have told you were crazy,” Bovett said.
Twelve years ago, 2.5 percent of people entering drug treatment abused prescription pills. In 2011 that number was almost 12 percent.
There is little argument among health officials, doctors and law enforcement that there is a very serious problem with prescription pills nationally, in Oregon and Coos County.
“Prescription drug abuse is a very serious problem across the country,” Burns said. “Everybody recognizes that to be 100 percent factual.”
In Coos County, prescription pills have led to increased abuse by juveniles and heroin use in adults. Data from the Coos County Commission on Children and Families show that this year, 10.1 percent of 11th graders admit to using prescription drugs in the last 30 days, compared to 7.4 percent statewide.
“Per capita, we are well above average,” Director of South Coast Interagency Narcotics Team Toby Floyd said of prescription pill abuse. “It is just an unsavory aspect of the community.”
A tsunami of pills
Over the past two years there have been 32 prescription drugs arrests throughout the county, and while that number might not seem high to some, police point out that most people selling prescriptions are obtaining them legally.
“The problem is way bigger than that number shows,” Capt. Cal Mitts of the Coos Bay Police Department said. “(The problem) hit here fast, like a tsunami and it hasn’t receded.”
Treatment facilities in the county, like Bay Area First Step, have seen admissions for prescription pills in both their transitional and residential housing programs go up within the last five years. Bay Area’s Executive Director Steve Sanden said admissions rose from 3 percent in 2008 to 12 percent in 2012.
“Opiate addiction is up, period,” he said. “The abuse of pain medication is up dramatically. It pretty much takes over their lives and becomes what they live for.”
Brenda Davis, 48, knows the harsh reality of pill abuse and the power of addiction. Davis got out of prison last year after serving two years on identity theft charges related to her prescription pill abuse.
Sitting behind a white table in a treatment facility, a now sober Davis reveals how she used to drive from hospital to hospital on the South Coast, faking injuries for pills. Her eyes widen as she talks about overdosing on methadone a day before she was sentenced.
“I am lucky to be alive,” she said. “I went against every value and moral in my life. I am powerless over it.”
Davis said although prison eventually saved her life, it didn’t stop her addiction.
“There are ways people work the system,” Davis said of getting pills in prison. “It’s pretty easy.”
Symptoms of withdrawal from pill abuse can include hallucinations, sweating and kidney pain.
Thirty-six-year-old mother of five Melanie Nash, still showing signs of withdrawal after 20 days of being sober, talks about what the pills did to her body and the dependency that still haunts her.
“I would rather come off meth than pills any day,” she said. “I had to pop a pill every couple of hours to keep from being sick. You want to die.”
Fifty-seven-year-old U.S. Navy veteran Doug, who refused to use his last name, recently was discharged from the hospital after attempting suicide due to his pill addiction. Doug said he started taking pills at age 9 after his mother was in an accident and had “more prescriptions than you can count.”
“It’s going to get you one way or another,” he said. “(Pills) brought out things in my mind I thought would never come back.”
Doctors push back
Pill abusers in Coos County say that while addiction is still very prevalent, pills are becoming harder to come by on the streets. Last year, the state started the Prescription Drug Monitoring Program — which licensed prescribers can sign up for to show them all of the potentially abusive drugs their patients are prescribed — to try and curtail “doctor shopping.”
Burns said as of April there were 64 licensed medical prescribers in the county who use the PDMP, and 3,400 across the state. Burns said the monitoring program is not designed to come down on people abusing drugs, but rather provide prescribers with information about what potentially abusive drugs their patients are picking up from pharmacies.
“It’s designed for doctors to have a resource to start conversations with their patients about why they are taking so many drugs,” he said.
Officials in the county believe small steps like the PDMP, the Drug Take Back Program — where people can turn in prescription drugs with no questions asked — and awareness by doctors, have made it harder to obtain prescriptions pills.
“Doctors are cracking down,” abuser Nash said. “Just within the last year, it is really hard to find them and street value is going up.”
“It is harder to obtain pills at this point,” Sanden said. “Doctors are just more aware.”
Floyd said most pills in Coos County are being bought on the street from people with prescriptions, obtained through burglaries or from people who are caring for the elderly.
Future of abuse
As Coos County and the state begin to make small steps toward disrupting the nation’s fastest growing drug problem, they are left with more questions than answers.
The most important of those questions may be: Where is the future of prescription pill abuse prevention headed?
“I don’t know if anybody has a firm answer,” Burns said. “The problem is nobody is quite sure how to resolve this.”
Bovett agrees that there is no “low-hanging fruit” solution, but he believes the answers have to come from the medical community. The dynamic of today’s medical culture — where doctors feel pressured to prescribe opiates and insurance rules are based on money, not community — have to change, he said.
“Oregon is in a searching stage,” Bovett said. “I don’t have any magic answers, but we have smart doctors working on it.”
Some of those doctors, as well as Burns and Bovett, are part of a task force assembled by Gov. John Kitzhaber’s office through a $45,000 grant from the National Governors Association. Oregon, along with six other states, was selected to be part of a coalition, headed by Alabama Gov. Robert Bentley and Colorado Gov. John Hickenlooper, to develop strategies on how to attack the problem.
Bovett said he proposed Gov. Kitzhaber establish a prescription drug task force with half of the members of the team from the medical community. He also said a meeting between the coalition earlier this week was helpful, and that the group got to hear the different “stages” each state was at.
“We have made minor strides, but not significant ones,” Bovett said. “Five years ago people didn’t know what the problem was.”
Burns said different organizations around the state have taken the initiative to help with the problem. He said the Oregon Medical Association had a detailed seminar on the issue; the Oregon Chapter of the American College of Emergency Physicians has adopted guidelines on how to prescribe medication; and the Oregon Health Plan enacted prior authorization requirements to limit the number of pills patients can get.
“We have options,” Burns said. “We can educate doctors and patients, find ways to get drugs out of medicine cabinets when patients are done and look at alternatives to treating people.”
Both Burns and Bovett agree that doctors are not part of the problem, but rather a big key to the future solution. Bovett insists that the state is headed in the right direction, and although he will be the first to admit there is a serious problem, he said he has seen worse.
“I am optimistic because we have people ready to take action,” he said. “We are talking about this now while we are seeing the trendline go up. We have a good start. It is bad, but not as bad as the meth epidemic.”
Reporter Tyler Richardson can be reached at 541-269-1222, ext. 236, or at firstname.lastname@example.org.