Painkillers

How Florida Is Fixing Its Prescription Painkiller Problem


Pain clinics are plentiful in South Florida, with almost 100 in Broward County alone, in 2009

Photograph by Stephanie Himango/NBCU Photo Bank via Getty Images

Pain clinics are plentiful in South Florida, with almost 100 in Broward County alone, in 2009

Florida was notorious in the past decade for pill mills that dispensed prescription painkillers with little oversight. The state now appears be turning the tide, recording two years of declining opioid deaths, according to new data released by the Centers for Disease Control.

In 2010, the CDC found, Florida was home to 98 of the 100 U.S. doctors who dispensed the most oxycodone. But drug overdose deaths dropped about 17 percent in the next two years amid a crackdown on pain clinics and a statewide system to monitor prescriptions. “These changes may well represent the first well-documented, substantial decline in drug overdose mortality in any state in the past 10 years,” CDC Director Tom Frieden told reporters.

Source: CDC

It’s hard to compare because national mortality numbers haven’t been tallied yet. A new formulation of OxyContin intended to be resistant to abuse—i.e., harder to crush and snort, inject, or smoke to get high—hit the market in 2010, which may have played a part. CDC officials say there was only a very small increase in opioid deaths nationally from 2010 to 2011.

But Frieden called it “unlikely” that other states mirrored Florida’s decline. “In at least one other state, we saw a decrease, but it was counterbalanced by an increase in heroin deaths, almost completely,” he said. The jump in heroin use isn’t necessarily caused by the painkiller crackdown, and while Florida’s heroin deaths increased slightly, the overall number of fatal drug overdoses dropped dramatically. “There was a real decline in not just prescription opioid deaths, but all drug overdose deaths, including illicit drugs,” Frieden said.

Overdoses from opioids—prescription medications such as OxyContin—have been at epidemic levels for years. The problem is so bad some local officials are taking drugmakers to court over it. Here’s what the national trend through 2010 looks like, according to the CDC.

Florida’s opioid use is still way above the national average. But Frieden says other states can learn from its experience by more closely tracking prescriptions, cracking down on pill mills, making treatment available to addicts, and equipping emergency responders with drugs that can save overdose victims.

Much of the overdose problem comes from overprescribing. That’s evident in the wide variation in how often doctors in different states prescribe opioids. “We don’t think it’s because people in some states have substantially more pain than other states,” Frieden said.

CDC Vital Signs, July 2014

John_tozzi
Tozzi is a reporter for Bloomberg Businessweek in New York.

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