Inside the coroner's office: Utah prescription drug deaths remain high

Flush a pill and save a life

Published: Friday, April 12 2013 6:20 p.m. MDT

SALT LAKE CITY — It was around 2001, down in the belly of the Utah Medical Examiner's Office, when Dr. Todd Grey and his colleagues started to notice a disturbing trend: Unexpected deaths were coming through the office without signs of trauma or explanation.

"It comes in as 'Mrs. Jones found dead in bed,'" Grey, Utah's chief medical examiner,  said. "No medical history would explain why she's dead and her doctor doesn't feel comfortable signing a death certificate. We do the exam and there's no physical abnormalities. Then we get the toxicology back and, boom, she's got a load of different meds in her system that clearly explain her death."

But solving the problem of abuse of prescription drugs was difficult. Year after year, the numbers rose, and Grey and his office started clamoring for some statewide attention about the issue.

"The problem is it's very complicated and there's lots of layers to how these people wind up dead," Grey said. "Some of it is clearly abuse, some of it is misuse, some of it is doctor ignorance. There's a whole bunch of factors that play into these deaths, so there's not some sort of magic bullet that we can shoot into this problem and solve it."

He said it was frustrating to see money spent on bioterrorism and smallpox while he and his fellow forensic pathologists were repeatedly seeing prescription drug overdose deaths. But the voices of the pathologists grew louder and lawmakers started to listen.

"There was a period a couple of years ago where they had done a lot of outreach with public service announcements … and we saw a dip in the number of drug deaths," he said. "Then the funding ran out and now we're seeing the numbers go back up."

He estimates that he continues to see around 400 prescription drug-related deaths each year, and "it's going to take a sustained effort to solve this problem," Grey said.

Liz Sollis, spokesman for the Utah Department of Human Services, said an initial campaign to tackle the issue in 2006 addressed unintentional overdose deaths. Her office took over efforts to raise awareness and has tried to increase education and encourage discussions about safe use, safe storage and safe disposal of prescription drugs.

The department's website, useonlyasdirected.org, generates some traffic, but Sollis said it is an issue with more of a "social responsibility." Most people who have prescription medications obtain them legally, making it harder for others to feel comfortable questioning their use.

"Because they are legal, people don't question it when other people pop a pill," Sollis said.

"If we reach into our bag and proceed to take a pill, no one is going to ask, 'Why did you take that?' Socially, it's more acceptable to use prescription medication and less acceptable to ask someone why they're taking the medication."

She said communities and families need to become more comfortable and understanding of the fact that while prescription medication can be beneficial when used appropriately, it is also a substance that can be abused with fatal consequences.  

"I would venture to bet that almost every person knows somebody: a family member, friend or co-worker who they suspect has a prescription drug problem," Sollis said. "It goes back to education and communication. In Utah, we talk around things and we don't necessarily talk to them. It's that elephant in the room and that elephant is a huge prescription bottle."

It's important for people to be honest with their doctors about their habits, she said. Alcohol, for example, can become potentially lethal when mixed with some medications. Safe disposal is also essential.

Sollis said agencies at the local, state and federal levels have worked together on the issue, as have private organizations. The way she sees it, the more conversation, the better.

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