Appalachia Addresses Appalling Abuse of Prescription Drugs

While prescription drug abuse affects all walks of life— urban, suburban, and rural— residents of rural counties are nearly twice as likely to overdose on painkillers as people in larger cities. And this fact rings true in Appalachia.

Coalitions throughout Appalachia have been working on strategies to solve the epidemic. For example, a state-wide conference “The Different Faces of Substance Abuse” took place recently in Kentucky. Catherine Brunson, a CADCA trainer, conducted a training on CADCA’s Rx Abuse Prevention Toolkit.

And the federal government is taking notice of the problem. Recently Gil Kerlikowske, Director of National Drug Control Policy at the Office of National Drug Control Policy, met with seven governors who are members of the Appalachian Regional Commission (Alabama, Kentucky, Mississippi, North Carolina, Pennsylvania, Tennessee, and West Virginia) to discuss the serious threat of prescription drug abuse to Appalachian communities and the Obama administration’s efforts to reduce drug use and its consequences through a public health and safety approach. During the meeting, Alabama governor Robert Bentley, Kentucky governor Steven Beshear, Mississippi governor Phil Bryant, North Carolina governor Beverly Perdue, Pennsylvania governor Tom Corbett, Tennessee governor Bill Haslam, and West Virginia governor Earl Ray Tomblin discussed the toll that prescription drug abuse has taken on Appalachian communities and actions state leaders are taking to prevent abuse and trafficking through education, information-sharing, interstate task force cooperation to crack down on “pill mills,” and treatment programs.

“The devastation wrought by prescription drug abuse on Appalachian communities is simply heartbreaking,” Kerlikowske told the group. “Prescription drug abuse is claiming too many lives, threatening public safety, and placing unnecessary obstacles in the way of economic prosperity in Appalachia. While we must ensure that Americans have legitimate access to lifesaving prescription medications, the Obama administration also remains laser focused on addressing this epidemic through a comprehensive public health and safety approach. All of us have a role to play in this effort, and I commend Governors from Appalachia for leading the way in recognizing the severity of this challenge and implementing evidence-based reforms to protect their communities from the misery caused by this epidemic.”

CADCA’s Chairman and CEO, Gen. Arthur Dean, will be addressing public and private stakeholders from across the country in sessions that highlight prevention, education, treatment and law enforcement efforts in addressing the prescription drug epidemic, particularly hard-hit Appalachia, at the inaugural National Rx Drug Abuse Summit. Organized by CADCA member Operation UNITE, headquartered in Kentucky. The Summit will take place April 10-12 in Florida. Other headliners include Florida Attorney General Pam Bondi, Director Kerlikowske and the Surgeon General Dr. Regina Benjamin.

According to the Centers for Disease Control and Prevention, deaths from prescription painkillers have reached epidemic levels in the past decade and now exceed deaths from heroin and cocaine combined. Prescription painkiller overdoses killed nearly 15,000 people in the U.S. in 2008—a rate of 4.8 deaths per 100,000 population. This rate is nearly four times the rate for 1999.

There is still a lot of work to do, but Bondi told attendees at the “Faces” conference that the "pill pipeline" between her state and Kentucky has been significantly reduced thanks to tougher regulations and the launch of a prescription monitoring program.

Kentucky Attorney General Jack Conway also spoke at the conference. He announced that he and House Speaker Greg Stumbo are close to finalizing a broad legislative package focused on pain management clinics and KASPER, the state's electronic prescription monitoring program, including: requiring prescribers who write scripts for certain controlled drugs to be registered; requiring KASPER reports be run on patients before pills are given out in emergency rooms; strengthening mandatory penalties for doctors who over-prescribe pills; and expediting the process of reviewing doctors who over-prescribe.

“It was amazing to have the attorney generals from both Kentucky and Florida at our conference,” said Sheila D. Barnard, Director of CADCA-member coalition Ohio County Together We Care in Beaver Dam, Ky. “As part of the planning committee for the conference, I thought it was important to have them there, as the Rx pipeline goes straight from Kentucky to Florida.”

Barnard said that 60 percent of the pills on the street in her state come from Florida.

The Food and Drug Administration provides guidelines for the proper disposal of unused or expired medicines, and ONDCP encourages the proper disposal of prescription drugs in an effort to reduce diversion. On April 28, the Drug Enforcement Administration will host another National Prescription Drug Take-Back Day. At last fall’s Take-Back Day, Barnard’s coalition collected 183 pounds of unused medications. She plans to participate in the event next month. The coalition is also close to securing a permanent drop box in their community. Barnard worked in a pharmacy before she worked in a coalition and saw some of the worst prescribing behavior, but now sees some of the best.

At the sold-out conference, Barnard said there were representatives from all aspects of their Rx abuse problem: public health, coalitions, University of Kentucky, clinicians, law enforcement and pharmacists.

“I do think physicians and hospitals are stopping the unnecessary prescriptions. A lot of education needs to get into the right hands and the coalitions are doing that. We’re all (going to) have to work together to combat this, though. It’s not just a Kentucky or Florida problem. It’s an interstate problem,” Barnard said.

To participate in a take-back event, visit www.DEA.gov.