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Crackdown on Florida clinics leads to decline in deaths, report finds

Medical ResearchLaws and LegislationPolitics and GovernmentU.S. Centers for Disease Control and Prevention
Deaths from OxyContin, Vicodin drop 26% over 2 years in Florida after a crackdown on clinics
Florida lawmakers bar pill mills from selling painkillers, deaths decline
The CDC declared an epidemic in painkiller deaths in 2011

Public health officials have identified a sharp decline in overdose deaths involving prescription painkillers for the first time in a decade.

Deaths involving OxyContin, Vicodin and other narcotic painkillers dropped by 26% over two years in Florida after a crackdown on pain clinics that dispensed high volumes of the medications, according to a government study released Tuesday.

Lawmakers there barred doctors in these "pill mills" from selling the drugs they prescribed.

"The results from Florida show that state action can make a difference, and confirms the tight correlation between prescribing and deaths," Dr. Tom Frieden, director of the Centers for Disease Control and Prevention, wrote in an email to Michael Botticelli, acting head of the White House Office of National Drug Control Policy.

Nationwide, fatal overdoses involving narcotic painkillers have escalated dramatically since 1999 to more than 16,000 a year. The increase in overdose deaths mirrors an expansion in prescriptions for the powerful drugs.

The surge in prescription overdoses pushed drugs past traffic accidents as a leading cause of preventable deaths in 2009 and prompted the CDC to declare an epidemic in 2011.

Amid the concern, doctors have written fewer prescriptions for some of the most popular painkillers in recent years, according to data compiled by IMS Health.

The decline in painkiller deaths in Florida is one of the first signs that efforts to address the crisis may be gaining ground, Frieden said.

"These changes might represent the first documented substantial decline in drug overdose mortality in any state in the past 10 years," he wrote to Botticelli.

The report, published Tuesday in the CDC's Morbidity and Mortality Weekly Report, echoes a 2012 Los Angeles Times study of 3,733 fatal prescription overdoses in Southern California. It found that drugs prescribed by physicians to victims played a role in nearly half of these deaths.

The Times study identified 71 doctors who prescribed drugs that led to three or more deaths. The doctor at the top of the list, a Huntington Beach pain specialist, has had 17 patients die of overdoses of drugs he prescribed, coroners' records show.

In the wake of The Times investigation, the Medical Board of California convened a task force that recently proposed new guidelines to advise doctors on the proper use of narcotic painkillers, and the state Legislature enacted laws giving the board more power to investigate potentially reckless prescribing.

The type of pill mills that were a problem in Florida have not been identified as an issue in California, so it's not clear what effect the Florida measures would have here.

In a second study released Tuesday, the CDC found that doctors in Alabama and West Virginia wrote more than twice as many prescriptions for narcotic painkillers in 2012 as their counterparts in California and Hawaii.

But it's not because there is so much more pain in one state than another, the study found. Instead, researchers attributed the variance to regional differences in attitudes toward treatment, as well as the prevalence of narcotics abuse and of pill mills.

lisa.girion@latimes.com

Twitter: @lisagirion

Copyright © 2014, Los Angeles Times
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Medical ResearchLaws and LegislationPolitics and GovernmentU.S. Centers for Disease Control and Prevention
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