Dr. Nicholas Hagemeier stands in front of the Bill Gatton College of Pharmacy. (Tony Casey/Johnson City Press)
A recent report from the Centers for Disease Control and Prevention put Tennessee just behind Alabama in the list of states that are prescribing the most powerful painkillers at the highest rate.
Using data collected in 2012, an article from the Associated Press said Southern states were in the worst standing for prescriptions per 100 people, with Alabama prescribers handing out 143, Tennessee closely behind and West Virginia, Kentucky, Oklahoma, Mississippi and Louisiana following in that order.
To put national numbers into perspective, CDC Director Dr. Tom Frieden said the numbers spread enough prescriptions across the country to provide every American adult with a bottle of pills.
The prescription pill problem has been linked to the nation’s rising rate of overdose deaths as well as the widespread toll it puts on communities and local economies, something that hits close to home in East Tennessee.
Dr. Nicholas Hagemeier, an assistant professor at East Tennessee State University in the Department of Pharmacy Practice, acknowledges that the numbers are bad, but says they’re anything but shocking. He said this issue is not something to come at from just one angle, which might be cutting off a doctor’s ability to prescribe drugs — such as hydrocodone, oxycodone and other opioids — but to consider it from different approaches.
If you cut off a person’s ability to receive opioids from their doctor or pharmacists, the evidence shows that many will end up with an addiction to heroin, Hagemeier said.
That example is just one of many that need to be considered, he said, saying that the 2012 data comes in before Gov. Bill Haslam’s nearly 90-page Prescription for Success that came out recently, but isn’t represented in the CDC’s numbers.
“I think as a state, we’ve taken some good steps to fix that,” Hagemeier said about the problem looking ahead.
The numbers the CDC puts out in a few years might show a significant amount of progress in Tennessee, he said, which keeps him optimistic.
“There’s a lot of variability across the states and that’s what this study pointed out,” he said. “But the conditions themselves can’t explain the variability.”
A lot of this has to do with the subjective nature of treating pain, something that he says is a difficult task for physicians. Among other things, it’s often done on a 1-10 scale for doctors and patients. Communication about pain levels, past prescriptions that have or haven’t worked and a more understanding approach to treatment.
“It’s hard,” he said about communication of pain levels. “There’s inconsistency in guidelines, though Tennessee is coming out with prescribing guidelines now. That’s a step.”
A success story reported in the CDC’s information showed that Tennessee required prescribers to check the state’s CSMD in 2012, which resulted in a 36 percent decrease in patients who were seeing multiple prescriber sources to obtain the same drugs that would have put them at a higher risk of overdose.
Other findings in the CDC’s report show 46 people die from a prescription painkiller overdose every day in the U.S., and that 10 of the highest prescribing states for painkillers are in the South.
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