Shortly after Mickey died, in the Summer of 2011, I was invited to the Rx Summit held just this April past. I had already begun to gather information on drug deaths in Kentucky’s Congressional District 5. I have worked most of the year since then to present the data for a paper that might have been put out at the Summit. Fortunately, or unfortunately, as the case may be–the paper and the data did not come together, easily. I was the principal investigator in a survey of Coroner held Death Certificate Data. This ”drug death survey” screened 1861 drug-related deaths in over two thirds of District 5. There are problems with the data: uneven collection across the area, not all counties represented, not enough time to organize the data available in a coherent format–to name a few. I did not attend the summit.
Given those problems, there was a significant amount of infomation that came out of informal interviews with coroners, from family members of deceased drug users, as well as anecdotal data from the death certificate filings. Patterns of risk emerged. Persons who die from overdose 1) tend to have been using the combination of benzodiazepines and opiates or alcohol for more than a year, licitly or illicitly; 2) have often had more than one previous overdose; 3) have a steady source of income to procure the drugs; 4) belong to a drug using social group and/ or family; 5) have already experienced the death of a close family member or friend due to overdose; 6) were not in treatment for addiction (including legally sanctioned treatment) or attended sporadically; 7) chose medical providers who did not do drug screens or pill counts; and 8) routinely ignored medication warnings by citing conflicting experience, or discounted medical opinion about the seriousness of a particular overdose event. Many persons who died had all of the “risks” listed. All of the persons who died had three or more.
Keep in mind that this is an unfunded study, in the sense that no specific federal or state dollars were budgeted for it. Certainly, I was on payroll, as were others who helped during the brief time available; but the information will be useful to my employer. It begs the question: Why has no state or federal agency looked into deaths of a magnatude greater than any killer disease in the past hundred years. Only recently, has the CDC pronounced these drug deaths as an epidemic–yet so little is known about the process that it has been termed a “prescription drug epidemic.” Technically most of the benzodiazepines and opiates used were ‘prescription’ at some point; but no accurate data exists on exactly how many of the deceased were using their own, or bartered, drugs. It is safe to say that a huge percentage of these deaths occurred to persons using drugs prescribed for others. A more accurate word choice would term it a “drug-induced death epidemic.”
How did the prescription drug summit address this issue? Actually, it didn’t. Instead it paraded out the one legal control that has proven somewhat effective: a prescription drug registry know in Kentucky by the acronym KASPER, that provides doctors and pharmacists with a useful tool for determining persons who are drug seeking. It would also cast some light on doctors who are carelessly prescribing–but the medical lobby has so far prevented that from being done. So efforts to legally intervene in the problem were spotlighted and everyone tsk-tsked about the awful death toll–and the summit provided all the purveyors of this completely inadequate drug policy with good food, and a pat on the back. Attaboy! Meanwhile a death rate of unimaginable magnitude grows by the day and no one has a clue as to why.
Take a look at the list of Risk Factors for Overdose above. Does it suggest another series of laws to catch persons who are ill, or education and treatment on demand for persons with the disease of addiction? I think Operation UNITE wasted its money and the suspect money of the drug companies that pitched in to assure that nothing bad for business occurred. I think the summit was the nadir of political posturing at the expense of seriously ill persons who need answers and real concern for their plight. Persons with the disease of addiction.