New statistics show physicians in Connecticut are continuing to prescribe fewer opioids to their patients, but the number of deaths associated with the powerful painkillers continues to remain high in the state.
Last month, the Office of the Chief Medical Examiner reported that 1,017 people died in 2018 from accidental overdoses, 948 of which were opioid-related. While slightly lower from the 961 opioid-related deaths in 2017, the figure is still considerably higher than the 298 in 2012.
Dr. Gregory Shangold, an emergency room physician and chairman of the Connecticut State Medical Society’s Opioid Committee, isn’t entirely surprised by the contradiction. He said a lot of the political and policy decisions surrounding the state’s opioid problem have focused “too much weight on physicians being the cause of the problem.”
He noted there are growing numbers of people who get addicted without starting on pills. Meanwhile, the vast majority of those who do begin with pills didn’t obtain them directly from a single provider, but rather bought them illegally, got them from friends or otherwise purposely misused them.
“So, us reducing prescriptions decreased that inventory out there. But it wasn’t the whole problem,” he said.
As an ER doctor with Hartford HealthCare, Shangold said he sees the need to make overdose-reversal drugs more readily available. Also, he said there are a not enough detox beds in Connecticut, especially in treatment programs with medication-assisted therapy.
When people come to an emergency room for help, Shangold said there’s a “finite amount of time” to persuade them to seek drug treatment.
“If you call around and there’s not a bed and there’s not a program slot and you say, ‘Oh, you’ve got to wait two or three days,’ you might have missed your opportunity,” he said
He added that there are other people who aren’t ready for treatment.
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“So the idea is, how do you keep those people alive until they are ready to accept treatment?” he said. “And that’s where I think we can make the most immediate dent into opiate deaths.”
The Department of Consumer Protection’s Drug Control Division announced last week there were 1.9 million opioid prescriptions processed in 2018, down from more than 2.1 million in 2017. There were more than 2.5 million opioid prescriptions filled in 2016 and more than 2.6 million in 2015.
The agency also found a decrease in benzodiazepine prescriptions, from more than 1.6 million in 2015 to 1.5 million last year. These drugs, which are primarily used to reduce anxiety, can be dangerous when combined with opioids.
Consumer Protection Commissioner Michelle H. Seagull said she believes recent Connecticut laws that require pharmacists to report daily the opioid medications they dispense and require physicians to look up their patient’s medication histories have helped. But she agrees more needs to be done.
“The fact that we’re slightly under 2 million (opioid prescriptions) now is good news. But there’s still a lot of these drugs out there and there’s still a lot of risk associated with them,” said Seagull. “So we certainly haven’t solved the problem. We’re just now starting to see some numbers moving in a positive direction.”
Last week, Democratic Gov. Ned Lamont announced a statewide awareness campaign that will feature information about opioids, treatment options, services and advice for families. The Department of Public Health is also administering a new smartphone app that provides information on overdose-reversal drugs, including how to administer them.
When he was a candidate last summer, Lamont said he would create an “opioid czar” after a batch of synthetic marijuana was blamed for sending dozens of people in New Haven to the hospital. The new Cabinet-level position was supposed to oversee the state’s handling of the opioid epidemic, but Lamont has not yet appointed anyone.