Avoyelles has high rate of prescription opioid drug use

While prescriptions for painkillers has declined nationwide from 2010 to 2015, the use of opioid drugs in Avoyelles remained “stable,” keeping the parish ranked high in use of those drugs.

Prescriptions are measured in “morphine milligram equivalents” (MME) per person. The national average declined from 782 MME per person in 2010 to 640 MME per person in 2015, according to a U.S. Centers for Disease Control and Prevention report. That equates to an 18 percent decrease.

Avoyelles usage rate was 947.7 MME per person in 2010 and had dropped slightly to 937.5 MME per person in 2015. Avoyelles ranks in Category 3 of a four-category rating, with Category 4 being the highest-use group. The parish came just 21.5 units from being included in the top category with neighboring parishes Rapides, Evangeline and St. Landry.

CDC Acting Director Dr. Anne Schuchat said half of the country’s counties saw a decrease in opioid prescriptions during the study period.

Despite the good news of an overall decrease in opioids, the CDC report noted usage is still about three times greater than it was in 1999.

"We're still seeing too many getting too much for too long," Schuchat said. "The amount of opioids prescribed in 2015 was enough for every American to be medicated around the clock for three weeks."

Opioid is a class of drug primarily used to relieve pain. They may be derived from the opium poppy -- such as opium, morphine and heroin -- or synthetic drugs such as hydrocodone (Vicodin), oxycodone (Percocet), codeine, methodone and others.

“The numbers are not surprising and it’s horrible,” Avoyelles Parish Corner Dr. L.J. Mayeux said of the parish’s opioid use statistics. “Unfortunately, I see the number of overdoses that have led to deaths each year.”

There are 12 to 15 deaths due to these drugs each year. Some are accidental and some are suicides, Mayeux said.

“The abuse and and misuse is tied into our high suicide rate in Avoyelles Parish, which is leading the nation,” Mayeux continued. “The opioids are popular and easy to obtain.”

The drugs are used for treating chronic pain but can have adverse effects. Those using the drugs can develop dependence and experience withdrawal if they stop taking the drug.

Patients and their doctor should discuss any decision to stop taking these medications to avoid withdrawal symptoms.

Opioids are usually safe and beneficial when taken under the supervision of a medical professional for a short period. However, they are potentially addictive and dangerous when taken inappropriately or without proper medical supervision.

There is a difference between being “dependent” on a drug and being “addicted” to a substance.

Dependence is when the body has become accustomed to the medication. Addiction is a condition where the substance interferes with one’s life in some way.

Drug store burglaries have risen sharply in recent years. The most recent was a July 9 break-in at Parrino Drug Store in Bunkie. The thieves reportedly took a large quantity of opioids.

“This hurts the pharmacy because of the cost of the drugs stolen and then the cost of replacing them,” pharmacist and owner Bruce Soileau said. “Then the drugs are illegally on the streets of our community.”

Another pharmacist, who didn’t want to be identified, said, “You would be shocked at the number of people, some you never would expect, who are coming in here for painkillers .. .some have been coming in for years.”

PRESCRIPTION PATTERNS

The CDC analyzed retail prescription data from QuintilesIMS in the nation and in Avoyelles Parish. Parish-level factors associated with higher amounts of opioids prescribed include:

• A greater percentage of non-Hispanic white residents.
• A greater prevalence of diabetes and arthritis.
• Micropolitan areas (non-metro small cities and big towns).
• Higher unemployment.

“While some variation in opioid prescribing is expected and linked to factors such as the prevalence of painful conditions, differences in these characteristics explain only a fraction of the wide variation in opioid prescribing across the United States,” Dr. Deborah Dowell of the CDC said. “This variation highlights the need for healthcare providers to consider evidence-based guidance when prescribing opioids.” Dowell is the chief medical officer in the Division of Unintentional Injury Prevention at CDC’s National Center for Injury Prevention and Control.

Mayeux said changes are coming in the medical profession to guard against “doctor shopping” for opioids.
“There will be changes for the number of pills a patient can receive each month,” Mayeux noted. “A new computer program will allow a physician to get on a nationwide data base to see if a patient is in contact with another doctor in Louisiana or out-of-state and receiving a prescription for opioids.”

Not only will this deter “doctor shopping” for prescriptions, it will make doctors and pharmacists more accountable for the number of pills issued.

Mayeux said in the past, doctors had no way of knowing when patients went to other doctors. That is no longer the case as technology exists to catch those multiple prescriptions. This will not only crackdown on doctor shopping from town to town, but on patients who jump over the state lines to neighboring states.

OPIOID WITHDRAWAL

Mayeux said eliminating use of opiates and opioids safely involves gradually reducing the painkiller dosage -- not all at once.

Some people can develop a dependence on painkillers within a matter of weeks. Tapering off the drugs helps to avoid unpleasant withdrawal symptoms.

This process could involve the use of another pain-relieving medication to ease withdrawal symptoms and prevent breakthrough pain, Mayeux said.

“You may be able to go through withdrawal treatment at home if you have a strong support system and appropriate medications,” Mayeux continued. “But some people need the support of an inpatient detoxification program or a hospital admission.”

Withdrawal symptoms include anxiety, rapid heart rate, higher blood pressure, excessive sweating, abdominal cramping, nausea/vomiting, diarrhea, trouble falling/staying asleep, muscle aches, “restless legs” and dilated pupils.

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