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Deadly addiction to prescription drugs rises in region

Tawny Watkins started taking the prescription medication Percocet four years ago to help relive the moderate to severe pain she suffered after giving birth to her daughter, Briella, by Caesarean section.

But even after her pain subsided, Watkins said she pretended to need the medication because “I loved the way it made me feel.”

The 27-year-old’s love was so strong that it quickly turned to dependency on the powerful painkiller — an opioid that affects the brain and central nervous system, creating a feeling of euphoria.

When her doctor stopped filling her prescription, Watkins discovered it was easy to buy Percocet and other prescription painkillers on the street.

Watkins — who said she never experimented with drugs before getting hooked on painkillers — could be the poster child for a growing statewide epidemic that has resulted in the accidental overdose deaths of more than 5,000 Ohioans in the past decade.

The Dayton Daily News poured through reams of data from the Ohio Association of Alcohol, Drug Addiction and Mental Health Services, the Ohio Department of Health, Ohio State Board of Pharmacy and other state and local agencies and conducted dozens of interviews with substance abuse counselors, law enforcement officials, addicts and their families and others throughout Southwest Ohio to take a closer look at the prescription drug issue in our community.

“The pills are everywhere,” said Watkins, who grew up in Kettering. “I used to take the bus downtown, and people would just walk up to you on the street and ask you if you wanted to buy some, even offer free samples. But I didn’t even know you could get hooked on them.”

Like many who become addicted to painkillers, Watkins eventually turned to heroin, another opioid, and other illicit drugs that mimic the affects of prescription painkillers but are cheaper to buy.

“I was taking 40 to 60 milligrams of liquid methadone, and shooting 100 to 200 milligrams of heroin a day,” said Watkins, who is now in recovery. “That combination is deadly.”

Opioids depress breathing and can cause people to suffocate to death when they take too much.

Epidemic hits rural, suburban areas hardest

Statewide, young women like Watkins now account for nearly half of all opioid addicts, more than 90 percent of whom are white and from largely middle-class families, according to the most recent report from Gov. John Kasich’s Governor’s Cabinet Opiate Action Team.

“Historically, this has been an urban problem,” said Orman Hall, director of the opiate action team.”That is not even remotely true today. Most of the people addicted to prescription opioids and heroin live in rural and suburban communities.”

Still, urban areas are not immune, and opioid abuse has become a statewide epidemic that must be addressed on on multiple fronts, Hall said: “The opioid problem in our state is really a two-headed beast; it’s prescription opioids and then it’s heroin. Virtually nobody starts out on heroin. The vast majority of people who are addicted to heroin started out on prescription opioids.”

Those prescriptions are readily available: In 2011, enough opioid prescriptions were filled to supply 67 pills available for every man, woman and child in Ohio, according to state pharmacy board statistics. That compares to seven pills per capita in 1997.

And there has been a strong correlation between the increase in the amount of opioids prescribed and the increase in overdose deaths. Unintentional poisonings from prescription opioids alone have more than quadrupled from 199 in 2001 to 789 in 2011, state health department figures show.

“We’ve seen a lot more deaths from prescription overdoses in recent years,” said Wendy Doolittle, chief executive at the McKinley Hall drug rehab center in Springfield. “We had 39 overdose deaths in Clark County last year (more than twice the number from 2010), and most of them were opiate deaths.

“We used to serve maybe 20 percent, at best, opiate addicts,” Doolittle continued. “Last year, they comprised 80 percent of the addicts we treated. Prescription drugs are taking a huge toll on this community.”

Lawmakers crack down on pill mills

The high mortality rate for prescription drugs led state lawmakers in 2011 to pass a slew of ambitious reforms aimed at giving authorities better tools and broader powers to crack down on doctors who recklessly prescribe painkillers and other commonly abused drugs.

That included an update to the state’s prescription drug monitoring program, which uses an electronic database to track prescriptions by patients and can flag misuse by tracking multiple prescriptions by different doctors — a practice known as “doctor shopping.”

And earlier this month, the Opiate Action Team announced new opioid prescribing guidelines as part of an ongoing effort to curb the misuse and abuse of prescription pain medications.

But while the crackdown on pill mills and unscrupulous doctors may be helping to solve one problem, it’s contributing to another, said Andrea Hoff, director or community engagement and special initiatives for the Montgomery County ADAMHS board.

“The state has done a very good job of curbing those prescribing practices,” Hoff said. “But that certainly doesn’t mean that the people who needed help with addiction were getting it. As pills become scarcer, addicts just turn to heroin to get their fix.”

While prescription drugs are still the biggest killer statewide, the number of Ohioans switching from prescription drugs to heroin is on the rise, resulting in a dramatic increase in heroin-related deaths, which shot up from 117 statewide in 2006 to 426 in 2011.

Heroin deaths outpace opioid poisoning

While last year’s numbers have yet to be finalized, Hall said he expects to see heroin deaths outpace prescription opioid deaths for the first time in 2012.

“Heroin deaths are beginning to overtake prescription drug deaths in every part of the state,” he said.

That includes Southwest Ohio.

“We are seeing mortality rates from heroin at levels we’ve never seen before in any other drug epidemic; not crack, not anything,” Hoff said. “And it’s impacting a very broad range of socio-economic groups.

“Certainly, it’s still in the inner city of Dayton,” she said. “But some of our highest overdose rates are also in the northern suburbs.”

John Bohley, executive director of the Butler County Alcohol & Drug Addiction Services Board, said the prescription opioids are still the biggest killer in the county, but that’s beginning to change.

Prescription opioid deaths surged from four in 2000 to 50 in 2011, Bohley said.

“There hasn’t been that kind of dramatic increase in heroin deaths yet,” he said. “But that’s the concern. And we’re also hearing stories about people migrating from abusing prescription drugs to abusing heroin.”

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