New National Vital Statistics data released early this month showed that the American life expectancy has reached a record high: a child born in 2009 has a life expectancy of 78.5 years, up 0.4 years since 2008. The data also showed that the racial life expectancy gap, or the difference in projected life expectancy for Black and White Americans, is at a historical low. Unfortunately, while health outcomes have improved for Black Americans, the narrowing is also due to slowing improvement for Whites.
So what’s happening? For White Americans ages 20-54, unintentional poisonings — primarily accidental prescription drug overdoses — have surpassed car crashes as the leading cause of death related to unintentional injury.
The problem is especially bad in Oklahoma, which in 2010 boasted the fourth-highest rate of death via unintentional poisoning in the US. According to the 2007 National Survey on Drug Use and Health (NSDUH), Oklahomans exceeded the national average for misuse and abuse of painkillers by 232 percent – a 22 percent increase since 2004. For Oklahomans ages 25 to 64, unintentional poisoning is the leading cause of injury death. The majority of unintentional poisoning deaths result from the misuse and abuse of opiates (painkillers), distantly trailed by benzodiazepines (anti-anxiety medications). In 2007 in Oklahoma, prescription painkillers were responsible for 427 deaths — more than meth, heroine, and cocaine combined. Indeed, opiate addiction, which was once almost synonymous with heroine addiction, now almost exclusively refers to prescription medication in Oklahoma.
The vast majority of those who abuse prescription painkillers don’t purchase them from the stereotypical dealer on street corners. Almost one in five (17 percent) of those who used prescription pankillers nonmedically were prescribed the medication by a doctor; 72 percent got the medication from a friend or relative, and 60 percent of those were given the medication for free (eight percent purchased the medication from a friend or relative, and four percent took the medication without asking). Only four percent purchased the painkillers from a dealer.
The users of these drugs are also not who we might expect. As The Oklahoman wrote:
The casualties of drug abuse are not just hard-core addicts who buy bootlegged meth, crack and heroin from street dealers. They’re middle-aged and middle-class Oklahomans who start taking pain pills for bad backs and other injuries, never dreaming they could wind up tumbling down the slippery slope of addiction, or worse yet, dying from an overdose.
By all accounts, prescription painkiller abuse in the US, and in Oklahoma in particular, is now an epidemic. Annual costs of unintentional poisonings in Oklahoma top $40 million. After the prescription drug overdose of University of Oklahoma football linebacker Austin Box, Governor Fallin announced a plan to curb prescription drug abuse within five years. The state has a fairly comprehensive plan in place for reducing addiction — a report from Trust for America’s Health awarded it an 8 out of 10. Education on the issue is also badly needed – as Dr. Sanjay Gupta noted, “No one thinks having a few beers and an Oxycontin is a good idea, but you also don’t expect to die” — even though all too often, that’s exactly what happens. However, while education, disposal schemes and monitoring programs have enormous potential, none of them address the root problem: why so many painkillers are prescribed in the first place.
Hydrocodone and other painkillers do have valid, necessary medical applications. Furthermore, Oklahoma is an unhealthy state, ranking 44th worst nationwide for our citizens’ health. Oklahomans rank 42nd for poor physical health days, 45th for occupational fatalities (which suggests a similarly high level of occupational injuries), and have high rates of physical inactivity. Dental disease, a common source of severe pain, is also very prevalent in Oklahoma. Chronic pain is, in fact, undertreated in the US. In short, there are a lot of reasons in this state to prescribe painkillers. Perhaps the issue is less a need to restrict legitimate access to painkillers but to reduce the need in the first place.
Prescription painkiller abuse is a complicated, multifaceted issue with a lot of moving parts. Strong movement forward is already in progress. But there’s a long way to go to truly address painkiller addiction in Oklahoma.