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8/25/2015
Tennessee’s Prescription Drug Abuse Epidemic
Facts you need to know…
• According to the Tennessee Department of Health, 422 people in Tennessee died from drug overdose in 2001, the year that the Intractable Pain Act was enacted.
• That number has steadily increased over the years, reaching 1,166 in 2013.
• Also according to the Tennessee Department of Health, the number of babies born with drug dependency has increased 1,000 percent from 2001.
• 463 reported cases of Neonatal Abstinence Syndrome as of July 1, 2015.
• As of 2014, Tennessee has the 11th highest drug overdose mortality rate in the United States with 17.2 per 100,000 people. Prescription Drug Use is a Problem in Tennessee
• The top three most‐prescribed controlled substances in Tennessee in 2010 were:
• 275.7 million pills of hydrocodone (e.g. Lortab, Lorcet, Vicodin)
• 116.6 million pills of alprazolam (e.g., Xanax)
• 113.5 million pills of oxycodone (e.g., OxyContin, Roxicodone)
• Hydrocodone and oxycodone are both prescription opioids used to treat pain.
Source: Report to the 2011 107th General Assembly by the Tennessee Department of Health Controlled Substance Database Advisory Committee, Board of Pharmacy
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Prescription Drug Use is a Problem in Tennessee
• The number of drugs prescribe during 2010 to Tennesseans represents:
• 51 pills of hydrocodone for EVERY Tennessean above the age of 12
• 22 pills of alprazolam for EVERY Tennessean above the age of 12
• 21 pills of oxycodone for EVERY Tennessean above the age of 12
Source: Report to the 2011 107th General Assembly by the Tennessee Department of Health Controlled Substance Database Advisory Committee, Board of Pharmacy
Top 10 drug types reported to CSMD in Tennessee; 2012
Morphine products; 385,390;
3%
Buprenorphine; 409,940;
Diazepam; 514,977;
3%
4%
Lorazepam; 609,303;
5%
Clonazepam; 729,917;
6%
Tramadol; 833,436;
6%
Zolpiedem; 1,227,759;
10%
Oxycodone Products; 1,507,671;
12%
Hydrocodone products; 4,634,520;
36%
Alprazolam; 1,866,938;
15%
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Number of providers by state who wrote at least 3,000 prescriptions for
Schedule 2 controlled substances in 2012 in Medicare Part D
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The Number of Reported NAS Births Across the State Continues to Rise
2010
520
2011
610
2012
720
2013
855
2014
973
2015 (YTD)
463
0
200
400
600
800
1000
1200
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Reasons for Cautious Optimism
• The Repeal of the Intractable Pain Act
• Passed in 2001, the Intractable Pain Act was meant to perceived problem of chronic pain in Tennessee
• Doctors could refuse to prescribe controlled medications, but had to inform patients that there are doctors and clinics that specialize in pain treatment
• The law resulted in a sharp increase in the amount of controlled prescription medications, both legal and illegal
• Clinics that prescribed controlled medications for illegitimate reasons (aka “pill mills” were able to use the law as a shield against prosecution
• The repeal became effective July 1, 2015
Possible Next Steps
• There is still work to be done
• New laws could regulate doctors operating pain treatment facilities
• Require referrals before accepting new patients
• Require full examination of medical records
• Require psychological examination to look for patients who may be prone to addiction
• New initiatives to drive education on the dangers of prescription drug abuse
• Target children, teenagers, and populations in impoverished and/or rural areas
• Provide testing opportunities so parents can screen their children
• Provide additional resources for oversight of pain clinics and law enforcement investigation of illicit activities involving prescription medications
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Sullivan County District Attorney’s Office
Barry P. Staubus
District Attorney General for the 2nd Judicial District
www.sullivancountyda.com 8