As Rx deaths dip, heroin overdoses surge

Prescription drug deaths declined in 2012 for the first time in more than a decade, but a surge in fatal heroin overdoses wiped out the modest improvement, according to U.S. government statistics released Wednesday.

Fatal heroin overdoses rose 35% to 5,927, while deaths involving chemically similar prescription painkillers such as OxyContin and Vicodin dropped 5% to 16,007, for an overall increase, according to figures released by the Office of National Drug Control Policy.

The statistics reflect, at least in part, the switch among addicts from prescription painkillers to heroin, which is cheaper and can be easier to get.

“Overall, we are not winning,” said Andrew Kolodny, chief medical officer for Phoenix House, a national chain of addiction treatment centers.

Michael Botticelli, acting director of the Office of National Drug Control Policy, said the prescription death figures were a “promising sign” that initiatives in education, treatment and enforcement launched by President Obama in 2011 were taking hold. But, he said, there was still work to do to turn around the “devastating impact” of the drug crisis.

Painkiller deaths quadrupled between 1999 and 2011, mirroring a sharp rise in the number of prescriptions for such drugs dispensed by pharmacies. In 2009, overdoses involving painkillers pushed drug fatalities past traffic accidents as a cause of death. And in 2011, the U.S. Centers for Disease Control and Prevention declared an epidemic.

The crisis had long been blamed on pharmacy robberies, teenage pill poppers and the “black market.” But a 2012 Los Angeles Times study showed that physicians played an important role in prescription drug overdoses. The Times analysis of 3,733 fatalities found that drugs prescribed by physicians to patients caused or contributed to nearly half the deaths.

In response to overdoses and deaths, almost every state has created a prescription drug monitoring program so physicians can log into a computer to check whether a patient is getting a dangerous narcotic from another physician. And doctors have begun writing fewer prescriptions for some of the most popular painkillers, according to data compiled by IMS Health.

This year, CDC researchers reported the first sign that such efforts may be gaining ground. In Florida, they said, deaths involving narcotic painkillers dropped by 26% in the wake of a statewide crackdown on so-called pill mills that catered to addicts and dealers.

The latest rise in heroin deaths may be a sign that efforts to tighten up the supply of prescription painkillers is pushing addicts to use the illegal narcotic, said Amy Bohnert, a leading researcher in the field.

That, she said, presents a new policy challenge.

“The solutions so far have focused on how to change prescriber behavior, but the next step -- what to do with the patients affected by those changes -- hasn’t occurred,” said Bohnert, an assistant professor at the University of Michigan.

April Rovero, who founded the National Coalition Against Prescription Drug Abuse after her son Joey fatally overdosed on pills from a doctor, said she was pleased at the decline in painkiller deaths.

But, she said, “are we out of the woods? Absolutely not.”

lisa.girion@latimes.com
Twitter: @lisagirion