Narcotic painkillers receive scrutiny
As news of an opioid drug epidemic continues to garner national attention, local health professionals and law enforcement are doing what they can to see that is doesn’t spread here.
People know about addiction caused by illegal narcotics such as helium and opium, but prescription drugs that are used to treat pain can also become addictive. These include morphine, Demerol, Oxycontin, Percodan, Percocet, and Tylox, along with drugs with opioid additives such as Robitussin A-C and Tylenol with Codeine.
The feeling of euphoria that opioids produce causes many people to misuse them. An overdose of an opioid leads to respiratory problems. The person may even stop breathing and die.
While marijuana and methamphetamines are more prominent concerns locally, Sheriff Robert Craft said he sees from 12 to 20 cases of mostly illegal opioid drug abuse every year. He said some people who are found suffering from opioid abuse are put into protective custody.
Craft said local authorities haven’t seen any cases of fentanyl use. Fentanyl is an especially deadly painkiller. It’s 50 times stronger than heroin. It’s cheap, and a small amount can lead to death.
Amanda Baxa, a doctor at St. Luke Medical Clinic in Marion, said there was a time when doctors were accused of not doing enough to address pain, but now the pendulum has swung the other way.
She said opioids were pushed to take care of everything, but then the issue became one of doing more harm than good, and the need to back off.
“I think we did get some people in trouble, but we have to be careful to find a middle ground,” she said.
Her approach to patients dealing with pain is to start with something that has the least amount of side effects.
“You can start with non-drugs such as physical therapy, and then try over-the-counter Tylenol and Ibuprofen,” she said. “Studies have shown that they work as well as prescription pain medicine after surgery.”
If pain persists, other non-addictive medicines can be prescribed.
If all else fails, Baxa discusses the risks and benefits of using an opioid drug with the patient, and they come to a mutual decision.
She said if people think they are becoming addicted, the best thing they can do is share their concern with their physician and ask for help. She said she has helped patients get off of their medications.
Pharmacist Melissa Thomson of Hillsboro Hometown Pharmacy said a pharmacist’s job is to ensure that narcotic painkillers are appropriately prescribed and prescriptions are appropriately filled.
“Our job is to make sure it is a legitimate need,” she said. “Fortunately, being in a small town, we see the same people over and over and can spot where problems might exist,” she said.
Pharmacies have a statewide drug database that can be accessed to ensure someone isn’t getting double prescriptions for the same drug or that a prescription is legitimate.
Thomson said they look out for people who come in during a very busy time or at the end of the day in an effort to avoid suspicion.
If a regular customer comes in for a refill earlier than the prescribed length of the prescription and if their health is at risk because of increased use of the drug or use of other pain medication, pharmacists will consult with the customer’s doctor to consider other treatment options.
Thomson said insurance companies have tightened restrictions on addictive pain medications, limiting them to a maximum length of seven days.
She said one reason for this is that these drugs may unknowingly become available to others if left in a drug cabinet for a longer time. Other members of the household, visitors, or even house cleaners or utility workers might steal them to use or sell to others on the street.
“There is a big push for people to keep these drugs locked away,” Thomson said.
Naloxone, known by the brand name Narcan, can be administered as an antidote to an opioid overdose. It doesn’t solve the problem but can save a person’s life until he or she can get help. Thomson said the drug is expensive. Tablets are the least expensive but don’t work as fast as a nasal spray that costs $200 a dose.
Emergency medical director Ed Debesis said county emergency medical technicians carry Naloxone. Firefighters and law enforcement officers may carry it, as well.
The U.S. Surgeon General issued a directive Thursday advising more Americans to carry Naloxone if they are at risk for addiction or have family and friends who could be at risk. A prescription is required.
“Hopefully, a generic form of the drug will be available someday that won’t be as expensive,” Thomson said.
“As long as we have opioids, the potential for addiction will be there,” Baxa said. “We can do our best to prevent it, and I think we are doing a better job of it.”
Kansas State Research and Extension has released a new fact sheet about opioids: “The Opioid Crisis, What You Need to Know.” It is available at the extension office in Marion and online at ksre.ksu.edu.
Last modified April 12, 2018