September 16, 2014
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RX overdose a ‘public emergency’
OVERDOSES ON THE RISE: A graph courtesy of Dr. Michael Dacey, Kent Hospital’s chief medical officer, shows a drastic increase in life threatening drug overdose hospital admissions. The projected data for 2012 shows nearly double the amount of drug overdose patients this year versus 2011.

Ten days ago three people under the age of 26 were admitted to the Kent Hospital Emergency Room. They each were undergoing cardiac arrest due to prescription drug overdoses. Two of them died.

In light of their deaths, and the general increased rate of drug overdoses nationally, Kent Hospital held a conference yesterday to address the issue head-on.

Sandra Coletta, president and CEO of Kent Hospital, said the events of 10 days ago left a pit in her stomach.

“I couldn’t shake the feeling that … it could have been my 21-year-old son,” she said. “This is real. This is happening, and it’s in my ER. I don’t want it here.”

In the past five months drug overdoses have increased substantially locally and nationally. Kent Hospital saw seven drug overdoses in the last eight weeks, and five of the seven died. In 2011, there were only two deaths from prescription drug overdoses.

“Before 2011 I can’t recall when an overdose patient died,” said Dr. Michael Dacey, Kent Hospital’s chief medical officer, yesterday.

Dr. Michael Fine, director of the Rhode Island Department of Health (HEALTH), called the increased rate of death due to overdose a “public health emergency.”

“Abuse of prescription drugs is a huge growing problem,” he said.

Statewide there are three to five overdose-related deaths a week, said Fine. He said HEALTH would be working to address the drug abuse problem.

“We are being pretty tough,” he said. “We will be assisting law enforcement and we will be watching.”

Mayor Scott Avedisian called the statistics “disheartening,” and said the city is willing to cooperate with the hospital and law enforcement agencies to crack down on drug abuse, especially in young people.

Although prescription drug overdoses were the center of discussion at yesterday’s gathering, Dacey said the problem doesn’t stop there. Heroin overdoses are also on the rise.

“The dealer will step a person up – or down, depending on how you look at it – to heroin because it’s less expensive,” he said.

Craig Stenning, director of the Rhode Island Department of Behavioral Healthcare, Developmental Disabilities and Hospitals, said the notion that prescription drugs are safer than street drugs is wrong.

Projected data shows life-threatening drug overdose admissions at Kent will leap from 37 in 2011 to 67 in 2012. Deaths from heroin will rise from 33 in 2011 to 53 in 2012. Combined, the data shows a sharp upward spike: 70 total deaths in 2011 versus 120 in 2012.

The result nationwide is that prescription drug overdose deaths now outnumber motor vehicle accident fatalities. Dacey said the combination of better auto safety and increased access to prescription drug accounts for this statistical trend.

Dacey said the key factor about these stats is that they’re accidental.

“There is a slight increase in attempted suicide,” he said. “But there are people having accidental overdoses.”

“Narcotics abuse is a silent killer,” said Dr. Alan Gordon, associate medical director, substance abuse, Butler Hospital.

Gordon said although overdose may cause cardiac arrest, it’s ultimately lack of oxygen that kills the patients.

“These young folks are suffocating,” he said. “It’s more or less an on-off switch that … stops breathing.”

Gordon said, unlike alcohol, narcotics cause sudden deterioration.

“People look good and feel good until it’s too late,” he said. “You don’t get sloppy. It’s not that easy for parents to detect it.”

He said people taking prescription drugs are “trying to feel normal” and in many cases this is not a situation where they are trying to get high. On the positive side, he said, “there is treatment and it works.”

Gordon said mixing drugs with alcohol is another factor that leads to overdose.

“You start adding depressants [like alcohol or Vicodin] to narcotics and it’s increasing the suppression of breathing,” he said.

Hospital personnel also notice a delay in 911 calls, which affect the outcome of overdose treatment.

“Taking an overdose of a drug is not a crime,” said Dacey.

Captain Robert S. Nelson of the Warwick Police Department said the police do not see prescription drug abuse as often as the hospitals, but they do see drugs as the cause of many accidental deaths. Nelson encourages people to turn in their old prescription drugs.

“They come from family and friends – that’s where my people are seeing drugs taken from,” he said. “Do not hold onto them.”

Dacey said the problem isn’t restricted to low-socioeconomic neighborhoods. The overdose patients (equally men and women) are mainly young people, under 25, who receive the drugs from a family member or friend.

According to statistics, 55 percent of individuals, 12 and older who have used prescription drugs, obtained them for free from a friend or relative. Only 17 percent obtained them through an actual prescription, and 4 percent got the drugs from a dealer.

Stenning said increased public awareness, better training of health care professionals and the reduction of supply and demand are key components to resolving the crisis.

“We as a society think we should not feel pain,” he said, pointing out that marketing of prescription drugs is a major reason for the increased supply of prescription drugs.

Dacey echoed this, saying doctors are over-prescribing pain medication. Nationally, in 1997 doctors prescribed 95 milligrams of morphine equivalents per person. In 2009, the average dosage per person was 750 milligrams.

“It could be more prescriptions are being written, or other substances are less available,” said Gordon about the climbing overdose rates.

Though Kent is speaking out on the subject, Coletta pointed out that the issue is not just restricted to Kent County.

“It’s a statewide issue,” she said.

To help with the prescription drug problem, the Attorney General’s Office, Department of Justice Drug Enforcement Administration, the State Police and local police departments will host a statewide Prescription Drug Take Back Day on April 28 from 10 a.m. to 2 p.m. People can drop off unused and unwanted prescription drugs at designated sites with no questions asked.

For local drop-off sites, visit www.riag.ri.gov/documents/takebacksites.pdf.


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