Efforts to reduce rates of opioid prescription abuse appear to be meeting with success in Utah, according to a recent study that shows the number of overdoses from pharmaceutical narcotics remained steady between 2013 and 2016, after years of sharp increases.
However, rates of heroin overdoses climbed significantly in that period — a trend that would suggest it’s time to look closely at ways to break up the chain that leads patients who become dependent on painkillers to seek harder street drugs.
Law enforcement authorities for decades have been vigilant in going after heroin dealers, but that history has shown drug cartels are resilient and able to provide enough supply to meet the demand among addicts, even as police conduct frequent roundups and drug seizures. The key to success going forward will be continued law enforcement focus on dealers but also additional attention paid to ways to help those who have already become dependent on prescription drugs to avoid going to that desperate place where they feed their addictions.
It’s good news that rates of abuse of prescription painkillers are tapering, but that should be expected given the prominence of awareness and education campaigns lately focused on the prescribers and patients. There is no doubt physicians are taking more care in dispensing narcotic pain pills, while pharmacies have become more watchful for abnormal prescription patterns. Patients, too, are better educated about the risks of taking a drug with powerful addictive potential.
But now it’s becoming clear how often a routine narcotic prescription to treat pain can provide a person with a gateway drug that leads to heroin use once their access to pills is limited. According to the Utah Department of Health, 80 percent of heroin addicts nationwide first became hooked on prescription drugs. It stands to reason that if rates of prescription abuse go down, there will eventually be fewer potential heroin seekers.
To facilitate that, it’s necessary that anti-opioid efforts focus more directly on disrupting the link between pharmaceutical and street drugs. For those already fallen to heroin use, education and awareness campaigns are of little value. A successful effort will require three separate approaches.
First, health care professionals need to be better disposed to assist patients showing signs of dependency beyond simply cutting off their prescriptions. Counseling and support services to escape addictive behavior should be immediately available. We agree with Dr. Jenny Plumb, a pediatrician and director of the Utah Naxalone Association, who says patients who have become dependent on prescription painkillers shouldn’t be “cut off” without a plan in place to address their dependence.15 comments on this story
Second, it’s important there is an adequate supply of therapeutic resources in place to help heroin addicts who end up in the criminal justice system. Efforts in downtown Salt Lake City connected to addressing the homeless problem have already marshaled resources to that end. Given the scope of the heroin problem, it makes sense to consider whether adequate resources are in place statewide.
Finally, while reducing demand for heroin may be the most effective long-term approach, there remains a need for vigilance against the drug’s supply side. The war on street drugs has had little impact over generations in curbing the supply of heroin, but law enforcement authorities need to keep as much pressure as possible on those who peddle a drug that for too many people ends up as the final and fatal stop on the trajectory of addiction.