Opiates are on the rise

From the Ashland Daily Tidings, May 5 2009

Illegal use of prescription meds also up, experts say

Prescription medication abuse is on the rise in Ashland, say local drug addiction experts, and opiates appear to be the main culprit.

When used in small dosages under proper medical supervision, codeine, vicodin and morphine — each derived from the opium-producing poppy plant — are used as painkillers, and can be obtained through a doctor’s prescription. But they are highly addictive and, if used improperly, can be fatal.

“We’ve seen an increase in patients abusing prescription medications,” said Steve Fogelman, director of Kolpia Counseling Services. Kolpia is a privately owned treatment center with Ashland and Medford offices that specializes in drug counseling. While the two offices have reported different trends in illicit drug abuse, cases of prescription drug abuse have increased across the board.

“Oxycodone, oxycontin, percocet, vicodin, they’re all up,” Fogelman said.

Jackson County’s seven illegal drug-related deaths in 2008 marked a decrease from 10 the year before, according to the State Medical Examiner’s Office. But four of them were attributed to heroin, a narcotic derivative of morphine. A 34-year-old man recently survived an overdose on the drug at a restaurant in downtown Ashland.

“We’ve had some heroin increases over the last few years,” said Sgt. Jim Alderman with the Ashland Police Department. But he added that in Ashland “we don’t see a lot.”

Alderman does not believe any of last year’s heroin-related deaths occurred in Ashland. But information about medication abuse is harder to track, he said, “Because they’re obtained through the medical field.

“The problem with people abusing these drugs is that many people have prescriptions for them,” he said. “They are supposed to take one every six hours, and instead they take one every hour and a half.”

Opiates alter the amount of dopamine — transmitters of pleasure signals throughout the brain — in an individual. Whereas the flow of dopamine is usually regulated, opiates weaken the body’s ability to do so, resulting in the temporary euphoric feeling these drugs produce.

The body returns to normal, but after repeated uses the brain builds up a tolerance, requiring more of the drug to produce the same effect.

Long-term abuse of opiates leads to physical dependence, and can cause infections of the heart, lungs and liver. Unlike cocaine or methamphetamine, however, most opiates possess few exterior symptoms, making even chronic users difficult to identify.

“There are heroin addicts in the world that you’d never know were doing it,” Sgt. Alderman said.

While heroin is by far the most notorious of these drugs, medications containing opiates killed a greater number of Oregonians last year. Oxycontin is abused more than heroin, said Alderman, and in some cases is more addictive.

Dr. Tim Johnston with Southern Oregon Family Practice tries to prescribe them as rarely as possible, preferring just about any other pain relief technique — including meditation — to the use of opiates.

“I am quite aware of the addictive potential, and of the dependence that develops when people start taking opiates, so I try to recommend everything else and recommend patients try everything else.”

Oregon is currently one of twelve states without some form of prescription monitoring program to keep track of the drugs people are given. Oregon ranks among the top ten nationally in prescription drug abuse, and the top five in prescription abuse among teens.

Oregon Senate Bill 355, co-sponsored by Sen. Alan Bates (D-Ashland), would create a database for pharmacists to monitor individuals receiving prescription drugs. Advocates say the bill would drastically reduce the likelihood of doctors unknowingly prescribing drugs to individuals who are likely to abuse them.

In the meantime, police continue to monitor heroin trafficking in the Rogue Valley. But the near-fatal incident in the heart of downtown Ashland may have served to raise awareness of opiate abuse, and of its deadly implications.

“You can only take so much,” Alderman said.