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Oregon needs to work on its drug problem

The United States consumes 83 percent of the world’s oxycodone and 99 percent of its hydrocodone, according to a 2010 International Narcotics Control Board report. These are all generally classified as potent painkillers and sedatives, and are used for a wide variety of medical needs such as pain control, anxiety and depression.

In 2006, an Oregon firm called EcoNorthwest studied the “dollars and cents” impacts of such abuse. Its study noted total direct economic costs from substance abuse in Oregon totaled approximately $5.9 billion in 2006. These costs fell into the following three categories:

n $813 million in health care costs related to alcohol and drug abuse programs.

n $4.2 billion in lost earnings as a result of foregone productivity by users who die prematurely, are sick, fail to come to work or are incarcerated as a result of alcohol and drug abuse, and by victims of crimes committed by drug and alcohol abusers.

n $967 million in other costs such as violent, property, and consumption-related crimes; expenditures on alcohol and drug enforcement laws, criminal justice, and social welfare programs; and property damages attributed to motor vehicle crashes and fires.

Oregon health providers and leaders, as well as policy makers, should pay attention. A July 2014 study by the Centers for Disease Control and Prevention showed Oregon is fourth in the U.S. for long-lasting opioid prescriptions, 16th for high-dose opioid prescriptions and in the top half for overall opioid prescribing.

In running a pain management medical practice in Hood River, I see the harder side of how patients deal with chronic, life-altering pain issues. Sometimes the outcome is addiction to and abuse of the very pain relieving medications designed to help them.

Recently, the Federal Drug Administration approved a new ‘smart pill’ that medical research companies are introducing to render certain pain medications — those that are highly addictive and often abused, such as opioids and benzodiazepines — completely inactive when their form is altered.

If altered or abused, such smart pills can also be developed to have unpleasant side effects; to alter the timed release; and to only be ingestible when taken orally. Such formulations can go a long way to preventing continued abuse and, hopefully, addiction.

The good news is that health providers and advocates in Oregon are working together to prevent prescribing protocols that allow switching prescriptions of new abuse-deterrent medications with lower cost but addictive medications.

We are asking health leaders, prescribing providers and state policy-makers to follow the CDC’s report by examining prescribing practices to better control the possibility of abuse and overprescribing, so we all ensure continuity and cautiousness of care.

David Russo, D.O., is a physician and pain management specialist with Columbia Pain Management P.C. in Hood River.

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