Prescription painkillers

Wednesday, July 9, 2008 | 2:09 a.m.

Drug addiction normally conjures up images of junkies shooting heroin into their arms or teenagers induced by methamphetamine to ransack homes. It’s the pusher on the dark street corner. It’s the rave party fueled by Ecstasy. It’s the line of cocaine on the coffee table.

One would not normally equate the use of prescription painkillers with the dangers of meth or cocaine, but a stunning two-part investigative report in the Las Vegas Sun on Sunday and Monday by Marshall Allen and Alex Richards provided convincing evidence to suggest otherwise.

The report, which should be required reading for all Nevada lawmakers and health care professionals, revealed that more people die in Clark County from prescription narcotic overdoses than from overdoses of illicit drugs or from vehicle accidents.

How is that possible? Try the fact that Nevadans consume twice the national average of painkillers. Nevada led the nation in 2006 in per capita use of hydrocodone, more commonly known as Vicodin or Lortab. The state also ranked fourth in the nation for methadone, morphine and oxycodone use.

This is a subject that obviously has flown under the radar, and that’s the problem. Something as deadly as a rash of prescription drug overdoses demands immediate attention from the Nevada Legislature and from the Nevada Pharmacy Board.

More specifically, there needs to be a state law that would allow for more thorough analysis of a database maintained by the board that tracks all prescriptions for controlled substances in the state. Law enforcement agencies can tap into the database for active investigations, but authorities are not allowed to examine the information to help identify practitioners who may be overprescribing painkillers. That needs to change, and Assemblywoman Sheila Leslie, D-Reno, to her credit, vows to take action during next year’s legislative session.

Consider that last year 258 people died in Clark County from overdoses of prescription narcotics, compared with 197 who succumbed as a result of street drug overdoses. That statistical comparison alone should serve as a wake-up call to lawmakers that the use of the database must be expanded so that authorities can get a better handle on a public health crisis that has gotten out of control.

If a high percentage of the victims received their drugs from a small number of physicians, identifying those practitioners could prove useful in an effort to prevent future overdoses. This would not necessarily mean that the physicians involved are guilty of criminal conduct, but if the evidence points in that direction, they should be dealt with accordingly by the Nevada Board of Medical Examiners and by law enforcement.

Another aspect of the overdose problem is that it points to the need for more access to drug addiction treatment in Southern Nevada. Many overdoses undoubtedly could have been prevented with earlier detection of addictive behavior. But there are only 323 licensed substance abuse treatment beds in the county to serve a population of 2 million. Unfortunately, we will never know how many of last year’s overdose victims might have been on waiting lists for a treatment bed or were never referred to a program.

It is time to get serious about addiction to painkillers. The fact that these narcotics are approved by the Food and Drug Administration and hyped by the pharmaceutical companies is no excuse to brush this troubling dilemma under the rug and hope it simply goes away.