According to the Centers for Disease Control & Prevention (CDC) in their Morbidity & Mortality Weekly Report (MMWR) published on July 7, 2011, medical examiners in the state of Florida have seen a dramatic increase in prescription drug overdoses resulting in death between 2003-2009.
The report cites that only about 11% of the drug overdoses were suicides and less than 1% were homicides. The lion's share of the drug overdoses were determined to be "unintentional."
While several drugs are mentioned in the statistics, the star of the prescription drugs for this sad report appears to be oxycodone. The report cites over 264% increase in overdose attributed to this drug. Additional editorial notes in the MMWR report shed some light on the conditions in Florida.
What is Oxycodone?
Oxycodone is a generic name for a prescription pain reliever; brand names for it include oxycontin according to online drug information. Oxycodone is categorized by the National Institutes of Health (NIH) as an "opiate (narcotic) analgesic." It can be prescribed alone or in combination with ibuprofen or acetaminophen.
NIH warns that it can be "habit-forming" and will likely be prescribed in a low dose initially by doctors. The NIH list of possible side effects for oxycodone includes headache, mood changes, or more seriously, confusion, hallucinating, and loss of consciousness.
What Could Be Causing "Unintentional" Oxycodone Overdoses in Florida?
Looking for the root cause in the oxycodone issue is complex. Lots of finger pointing could be done. Some assumptions may be dismissed.
What's up baby boomers? Florida. The sunshine state. One of my favorite vacation destinations. The home of over 18 million people according to the 2010 census data is not disproportionately filled with older people who might be forgetful about taking their medications properly. In 2009, only about 17% of the state population was over age 65. Recent research from the medical examiners reveals it is a slightly younger age bracket plagued by oxycodone deaths there.
According to a Florida Department of Law Enforcement Report from 2009, the statewide oxycodone-related deaths were primarily in the 35-50 age group. There were more deaths reported in that age group from oxycodone than methadone that year. Does that mean baby boomers are more in pain than the elderly? Are they more abusive with prescription medications, frequently refilling and taking more and more without consulting with their physician? Or do they simply have more money to deal?
Is the medication conflicting with pre-existing medical conditions? Are people taking this medication who should not be? According to the drugs.com site, there is a list of existing medical conditions that should raise concerns to be discussed with a medical doctor before taking Oxycontin or oxycodone. Their list includes:
- asthma;
- COPD;
- liver or kidney disease;
- gall bladder disease;
- low blood pressure; and
- history of drug or alcohol addiction.
Doctors taking thorough medical histories should alert on any potential contraindications, and pharmacists filling prescriptions try to look for potential conflicts in medications. No research data was found in this review that related associated medical conditions with the causes of death.
Is it simply access to the drug? In April, 2010, online Time magazine ran an article by Thomas R. Collins reporting on the "pill mills in south Florida" as the state tries to get a grip on this situation. A similar report from March, 2011, by Bob LaMendola ran in the Sun Sentinel, Fort Lauderdale, FL.
A review of these and other online articles about the pill mills at least builds a case for drug access as a contributing causality. Perhaps overall, the oxycodone abuse epidemic is a classic result of lacking controls or self-discipline. The MMWR death report unfortunately shows the results.
What Is Florida Doing Now?
Eradication of abuse and misuse of oxycodone is proving a painful problem for Florida.
After declaring a public health emergency, Florida passed a new prescription law on June 3, 2011, according to the Florida Department of Law Enforcement (FDLE). On the heels of that new law, FDLE just initiated a compliance sweep on July 5 to try to increase awareness and assess physician compliance with new regulations. Twenty-three physicians are being inspected to ensure they have disposed of any stock of oxycodone.
FDLE is also heading up a drug strike force aimed at illegal trafficking of prescription drugs. Hopefully, these and other efforts will bring improvements in the next Florida medical examiners' reports.
New Research on How Oxycodone Helps in Japan
While some Americans are abusing oxycodone, recent research supports its use to improve lives in Japan. Head and neck cancer patients undergoing radiation treatments may experience painful side effects. So painful, according to Japanese researchers, that they can't eat properly and often have to stop the treatment.
In an abstract published in the August 2011 issue of Auris Nasus Larynx, Takase et al in Fukuoka, Japan, reported that head and neck cancer patients treated for mild pain with oxycodone during radiotherapy experienced "controls [of] the level of pain, improving food intake."
Meanwhile, the U.S. Embassy advises travelers to Japan that it is "illegal to bring into Japan some over-the-counter medicines commonly used in the United States," e.g., allergy and sinus medications containing stimulants such as pseudoephedrine (may include Sudafed, Vicks inhalers, etc.).
Conclusion
Use of any prescription medication should be under the strict, ongoing guidance of a licensed medical doctor. It may be a matter of life or death.
Disclaimer: The information and links contained in this article are for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact a licensed medical doctor for advice.This is an editorial review only. Readers should refer to original cited sources to ensure accuracy and for any interpretation of source material.
Sources
- Centers for Disease Control & Prevention (CDC). (2011, July 7). Morbidity and mortality weekly report (mmwr): Drug overdose deaths: Florida, 2003-2009. Retrieved July 7, 2011, from CDC government website.
- Collins, T.R. (2010, April 13). Invasion of the pill mills in South Florida. Time Magazine. Retrieved July 7, 2011, from magazine website.
- Drugs.com. (2011, April 26). Oxycontin. Retrieved July 7, 2011, from corporate website.
- Embassy of the United States, Tokyo, Japan. American citizen services: Importing or bringing medications into Japan for personal use. Retrieved July 7, 2011, from government website.
- Florida Department of Law Enforcement. (2009). Drugs identified in deceased persons by Florida medical examiners. Retrieved July 7, 2011, from government website.
- LaMendola, B. (2011, March 7). Florida no. 1 in oxycodone - by far. Sun Sentinel. Retrieved July 7, 2011, from newspaper website.
- National Center for Biotechnology Information. (2011, February 1). Oxycodone. Retrieved July 7, 2011, from PubMed Health online database.
- National Center for Biotechnology Information. (2011, May 16). Pseudoephedrine. Retrieved July 7, 2011, from PubMed Health online database.
- Takase, H., Sakata, T., Yamano, T., Sueta, T., Nomoto, S., & Nakagawa, T. (2011). Advantage of early induction of opioid to control pain induced by irradiation in head and neck cancer patients [Abstract]. Auris Nasus Larynx, 38(4), 495-500. Retrieved July 7, 2011, from EBSCOhost online database. DOI:10.1016/j.anl.2010.12.012.
- U.S. Census Bureau. (2011, June 3). State and County QuickFacts. Retrieved July 7, 2011, from government website.
- U.S. National Library of Medicine & National Institutes of Health. (2011, February 1). Oxycodone. Retrieved July 7, 2011, from Medline Plus online database.
