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New York’s problem with prescription drugs

By Matthew DeLuca     Aug 30, 2013 in Health
New York - Nationwide, overdose rates are increasing at an alarming rate. In some states, overdose deaths have surpassed traffic accidents as the leading cause of accidental death. As the death toll rises, many are asking what can be done to combat this trend.
The increase has been driven largely by the growing abuse of prescription opioids such as oxycodone and methadone. These substances, which are often obtained through a valid prescription, as opposed to drugs like heroin or cocaine that are traditionally associated with overdose, have been the driving factor behind increasing drug fatalities in recent years.
"How do we fight a war against a legal drug?"
An analysis, released by the New York City Department of Health in May, reported that between 2005 and 2011 the opioid analgesic overdose fatality rate increased by 65 percent despite the fact that during the same period overall drug overdose deaths decreased by 22 percent. As the drug-of-choice has changed, so too has the image of the traditional drug dealer and addict. Increasingly, those using and abusing these drugs are white middle-class citizens.
According to the same report released by the NYC Department of Health, 56 percent of opioid analgesic overdose fatalities occurred in middle or high income neighborhoods. These are also the neighborhoods where the largest increase in overdose fatality rates were observed. From 2005 to 2011 overdose fatality rates increased in middle income neighborhoods 115 percent while high income neighborhood experienced a 110 percent increase.
The results of the analysis also show that a vast majority of overdose victims are white. The fatality rate for whites was four and a half time higher that the fatality rate for blacks and three times higher than the rate for latinos.
Additionally, contrary to popular belief, the victims of overdose are not just young recreational drug users. In New York City the largest share of overdose fatalities occur in the age range from 45 to 54 years old, accounting for 27 percent of New York City’s opioid overdose fatalities. This is a troubling fact that makes clear the line between prescription misuse and the path to prescription opiate addiction.
Similarly, drug-dealers are no longer street criminals, clad in black clothing on a street corner but sit in their offices in white coats — today doctors are the drug-dealers, and while most doctors act only in the best interest of their patients’ health, a few have succumbed to greed and corruption, driven by a motive for profit and the high demand for prescription opiates in the illegal market. One such New York City medical professional, Dr. Hector Castro, was charged with diverting over $10 million of prescription drugs into the black market. Castro was arrested after he allegedly sold numerous oxycodone prescriptions to an undercover officer for $125 per prescription.
The case of Dr. Castro is not uncommon. In early June 2012, local and federal drug enforcement agents working on Long Island arrested 98 people in connection with illegal prescription drug distribution, including three Long Island Medical professionals responsible for illegally prescribing more than three million pills over a two year period.
Prescription drug addiction has also been a cause of violence as many addicted individuals will target pharmacies or medical establishments to obtain their drugs. In one 2011 case, four shoppers at a Medford, Long Island pharmacy were shot and killed as a man attempted to rob the pharmacy of its drugs, a crime, which Suffolk County Assistant District Attorney John Collins called, the "most cold-blooded robbery-homicide in Suffolk County history."
The alternative approach has been to implement harm reduction policies that will mitigate the negative effects of these drug. One such approach is the prescribing and dispensing of naloxone--a drug capable of reversing an opiate overdose. The drug is distributed to drug users and those close to them so that life saving treatment can be administered on the spot when an overdose is occurring. Policies that allow or encourage naloxone distribution in conjunction with laws that grant individuals immunity from drug possession charges when they call for medical attention for themselves or another, are extremely helpful in reducing overdose fatalities. Additionally, the granting of immunity under Good Samaritan laws, as they are commonly referred to, allows drug users to act in the best interest of health and allows them to save a life without fear of legal consequences.
States and localities have implemented a variety of policies in order to curb prescription drug abuse and limit overdose fatalities. One such strategy has been to monitor prescriptions with a statewide tracking system. Forty states have implemented such a system, which is used to track controlled substances that are prone to abuse. These systems allow doctors and pharmacists to check a patient’s prescription history and allow state officials to monitor the prescribing and dispensing habits of doctors and pharmacies in order to seek out illegal diversion of these drugs into the black market. These systems allow users to identify instances where there is a potential for abuse.
The fact that law enforcement has adjusted to the rising use of prescription drugs and has acted to limit the supply of these prescription drugs on the black market, has had unfortunate consequences. The consequences of these actions has been to shift prescription drug users, who have become hooked on opiates due to their misuse of a prescription, into the black market, forcing them to seek alternative methods to achieve the high they desire. Often times they will use heroin, which is a cheap and widely available substitute for prescription opiates. A 2009 study of Seattle heroin users concluded that 39 percent of heroin addicts reporting getting hooked on prescription medications before using heroin.
Ultimately, prescription drug abuse is a societal problem that has no easy solution. The ultimate solution may lie in better education about drug use and combating the drug culture that pervades in our society beyond circles of recreational drug users. In the end the question remains — how do we fight the war against a legal drug?
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