Prescription Drug Abuse: Strategies to Stop the Epidemic
Iowa has the Seventh Lowest Drug Overdose Mortality Rate in the United States
Iowa Scored Six out of 10 on New Policy Report Card of Promising Strategies to Help Curb Prescription Drug Abuse
Washington, D.C. October 7, 2013 – Iowa has the seventh lowest drug overdose mortality rate in the United States, with 8.6 per 100,000 people suffering drug overdose fatalities, according to a new report, Prescription Drug Abuse: Strategies to Stop the Epidemic.
The number of drug overdose deaths – a majority of which are from prescription drugs – in Iowa quadrupled since 1999 when the rate was 1.9 per 100,000. Nationally, rates have doubled in 29 states since 1999, quadrupled in four of these states and tripled in 10 more.
The report also finds that Iowa received six out of 10 possible indicators of promising strategies to help curb prescription drug abuse. Nationally, 28 states and Washington, D.C. scored six or less, with New Mexico and Vermont scoring the highest, with a 10, and South Dakota scoring the lowest with two out of 10.
According to the report by the Trust for America’s Health (TFAH), prescription drug abuse has quickly become a top public health concern, as prescription drug related deaths now outnumber those from heroin and cocaine combined, and drug overdose deaths exceed motor vehicle-related deaths in 29 statesN/A and Washington, D.C. Misuse and abuse of prescription painkillers alone costs the country an estimated $53.4 billion a year in lost productivity, medical costs and criminal justice costs. The report also notes that, currently, only one in 10 Americans with a substance abuse disorder receives treatment.
“Prescription drugs can be a miracle for many, but misuse can have dire consequences. The rapid rise of abuse requires nothing short of a full-scale response – starting with prevention and education all the way through to expanding and modernizing treatment,” said Jeffrey Levi, PhD, executive director of TFAH. “There are many promising signs that we can turn this around – but it requires urgent action.”
In the Prescription Drug Abuse report, TFAH – in consultation with a number of public health, clinical, injury prevention, law enforcement and community organization experts – reviewed a range of national recommendations and examined a set of 10 indicators of strategies being used in states to help curb the epidemic. There are indications that some of these efforts and strategies may be having a positive impact – the number of Americans abusing prescription drugs decreased from 7 million in 2010 to 6.1 in 2011, according to the National Survey on Drug Use and Health.
Some key Iowa findings from the report include:
| No. | Indicator | Number of States Receiving Points | |
|---|---|---|---|
| A “Y” means the state received a point for that indicator | |||
| 1 | Existence of Prescription Drug Monitoring Program (PDMP): Has an active program |
Y |
49 |
| 2 | PDMP: Requires mandatory utilization by prescribers |
N/A |
16 |
| 3 | Doctor Shopping Laws: Has a law specifying that patients are prohibited from withholding information about prior prescriptions from their healthcare provider |
Y |
50 and Washington, D.C. |
| 4 | Support for Substance Abuse Treatment Services: Participating in Medicaid Expansion, which helps expand coverage of substance abuse services and treatment |
Y |
24 and Washington, D.C. |
| 5 | Prescriber Education Required or Recommended |
Y |
22 |
| 6 | Good Samaritan Laws: Has a law to provide a degree of immunity or mitigation of sentencing for individuals seeking to help themselves or others experiencing an overdose |
N/A |
17 and Washington, D.C. |
| 7 | Rescue Drug Laws: Has a law to expand access to, and use of naloxone, a prescription drug that can help counteract an overdose, by laypeople |
N/A |
17 and Washington, D.C. |
| 8 | Physical Exam Requirement: Has a law requiring healthcare providers to physically examine patients or have a bona fide patient-physician relationship before prescribing a controlled substance |
Y |
44 and Washington, D.C. |
| 9 | ID Requirement: Has a law requiring or permitting a pharmacist to require an ID prior to dispensing a controlled substance |
N/A |
32 |
| 10 | Lock-In Programs: Has a pharmacy lock-in program under the state’s Medicaid plan where individuals suspected of misusing controlled substances must use a single prescriber and pharmacy |
Y |
46 and Washington, D.C. |
| Total | Six | ||
“Fifty Americans die a day from prescription drug overdoses, and more than 6 million suffer from prescription drug abuse disorders. This is a very real epidemic – and warrants a strong public health response,” said Andrea Gielen, ScD, Director of the Johns Hopkins Center for Injury Research and Policy. “We must use the best lessons we know from other public health and injury prevention success stories to work in partnership with clinical care, law enforcement, the business community, community-based organizations, and other partners to work together to curb this crisis.”
Key recommendations from the report include:
- Educate the public to understand the risks of prescription drug use to avoid misuse in the first place;
- Ensure responsible prescribing practices, including increasing education of healthcare providers and prescribers to better understand how medications can be misused and to identify patients in need of treatment;
- Increase understanding about safe storage of medication and proper disposal of unused medications, such as through “take back” programs;
- Make sure patients do receive the pain and other medications they need, and that patients have access to safe and effective drugs;
- Improve, modernize and fully-fund Prescription Drug Monitoring Programs, so they are real-time, interstate and incorporated into Electronic Health Records, to quickly identify patients in need of treatment and connect them with appropriate care and identify doctor shoppers and problem prescribers;
- Make rescue medications more widely available by increasing access for at-risk individuals to naloxone and provide immunity for individuals and others seeking help; and
- Expand access to and availability of effective treatment options as a key component of any strategy to combat prescription drug abuse.
According to the Centers for Disease Control and Prevention (CDC), nationally, sales of prescription painkillers per capita have quadrupled since 1999 – and the number of fatal poisonings due to prescription painkillers has also quadrupled. Enough prescription painkillers were prescribed in 2010 to medicate every American adult continually for a month.
“The release of the prescription drug abuse report by the Trust for America’s Health represents a significant step forward in elevating public awareness of the state of prescription drug abuse in the US”, according to Ginny Ehrlich, CEO of Clinton Health Matters Initiative (CHMI). “We are proud that the Trust has completed this important research as part of its CHMI Commitment to Action and congratulate the Trust on continuing to advocate for innovation and action towards addressing this public epidemic.”
The report was supported by a grant from the Robert Wood Johnson Foundation.
Score Summary: A full list of all of the indicators and scores, listed below, is available along with the full report on TFAH’s web site at www.healthyamericans.org and RWJF’s web site at www.rwjf.org/RxReport. For the state-by-state scoring, states received one point for achieving an indicator or zero points if they did not achieve the indicator. Zero is the lowest possible overall score, 10 is the highest. Data for the indicators were drawn from a number of sources, including the National Alliance for Model State Drug Laws, NCIPC, Centers for Disease Control and Prevention, the Alliance of States with Prescription Drug Monitoring Programs, the National Conference of State Legislators, the Network for Public Health Law, the Kaiser Family Foundation and a review of current state legislation and regulations by TFAH. In August 2013, state health departments were provided with opportunity to review and revise their information.
10 out of 10: New Mexico and Vermont
9 out of 10: Kentucky, Massachusetts, New York and Washington
8 out of 10: California, Colorado, Connecticut, Delaware, Illinois, Minnesota, North Carolina, Oklahoma, Oregon, Rhode Island and West Virginia
7 out of 10: Florida, Nevada, New Jersey, Tennessee and Virginia
6 out of 10: Arkansas, District of Columbia, Georgia, Hawaii, Iowa, Louisiana, Maryland, Michigan, North Dakota, Ohio, Texas and Utah
5 out of 10: Alaska, Idaho, Indiana, Maine, Mississippi, Montana, New Hampshire and South Carolina
4 out of 10: Alabama, Arizona, Kansas, Pennsylvania, Wisconsin and Wyoming
3 out of 10: Missouri and Nebraska
2 out of 10: South Dakota
STATE-BY-STATE DRUG OVERDOSE MORTALITY RANKINGS
Note: Rates include total drug overdose mortality rates, the majority of which are from prescription drugs. 1 = Highest rate of drug overdose fatalities,51 = lowest rate of drug overdose fatalities. Rankings are based on data from CDC’s National Center for Health Statistics, WONDER Online Database, 2010.The numbers are based on the number of people per 100,000.
1. West Virginia**** (28.9); 2. New Mexico (23.8); 3. Kentucky**** (23.6); 4. Nevada (20.7); 5. Oklahoma*** (19.4); 6. Arizona (17.5); 7. Missouri*** (17); 8. (tie) Tennessee** and Utah (16.9); 10. Delaware** (16.6); 11. Florida** (16.4); 12. Ohio*** (16.1); 13. Rhode Island** (15.5); 14. Pennsylvania (15.3); 15. Wyoming*** (15); 16. South Carolina*** (14.6); 17. Indiana**** (14.4); 18. Michigan*** (13.9); 19. Louisiana*** (13.2); 20. Washington (13.1); 21. (tie) District of Columbia and Montana** and Oregon** (12.9); 24. Colorado (12.7); 25. Arkansas** (12.5); 26. (tie) Alabama*** and Idaho** and New Hampshire** (11.8); 29. Alaska (11.6); 30. (tie) Mississippi***and North Carolina** (11.4); 32. (tie) Maryland and Massachusetts (11); 34. (tie) Hawaii and Wisconsin** (10.9); 36. Georgia*** (10.7); 37. California (10.6); 38. Maine (10.4); 39. Connecticut (10.1); 40. Illinois (10); 41. New Jersey (9.8); 42. Vermont** (9.7); 43. (tie) Kansas** and Texas (9.6); 45. Iowa**** (8.6); 46. New York (7.8); 47. Minnesota** (7.3); 48. Virginia (6.8); 49. Nebraska** (6.7); 50. South Dakota (6.3); 51. North Dakota (3.4).
** Drug Overdose Mortality Rates doubled from 1999 to 2010
*** Drug Overdose Mortality Rates tripled from 1999 to 2010
**** Drug Overdose Mortality Rates quadrupled from 1999 to 2010
Trust for America’s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority. For more information, visit www.healthyamericans.org.
