Prescription drug ODs outnumber alcohol-related ones in Plumas County
If you asked a group of your average Plumas residents what the largest cause of intoxication-related deaths in the county has been this year, excluding suicide, most people would probably guess it was DUI crashes involving alcohol.
If you gave them a hint and said it actually involved drugs they might guess that meth-related incidents would be the answer because methamphetamine is considered by many to be the largest hard-drug problem in the county and country.
According to county law enforcement, they would be wrong.
Six people have died in this county this year from accidental prescription-drug overdoses, although some of them did involve alcohol as well, but not nearly enough to be lethal on its own.
That’s one more death than from all alcohol-related incidental deaths combined.
This fact, coupled with other information, has led Plumas County Sheriff’s Office Investigations Sergeant Steve Peay to believe unauthorized prescription drugs represent the largest percentage of abusive drug use in the U.S. when compared to traditional hard drugs like meth or cocaine.
He added, “There’s just no statistics because it’s so legal to possess.”
Undersheriff Greg Hagwood commented pharmacists he talked to were shocked by the amounts of medications being prescribed in such a small county.
Peay explained that methadone, a synthetic opiate painkiller, was the biggest single prescription drug problem in the county right now, followed by oxycodone.
Hagwood added methadone was particularly dangerous because it was addictive, caused an intoxicating high that made it appealing, and mixed dangerously with illegal drugs, alcohol or other medications.
He emphasized the “alcohol and methadone combination has proven to be lethal in a number of these instances.”
The Quincy California Highway Patrol office has also noticed a sharp increase in dangerous prescription drug use, with 24 DUI arrests related to the problem in 2009.
Quincy Area CHP Commander Paul Davis explained that number didn’t include incidents in which people were arrested with prescription drugs and over a .08 blood alcohol level as those were counted as alcohol DUIs.
Davis said it was the biggest year for prescription drug DUI arrests that he was aware of in the county’s history.
Hagwood said the problem was frustrating in part because it didn’t get as much attention from the public as other intoxication issues had in the past.
“I’ve been very troubled by the number of fatalities that we’ve had because if we were having the same number of fatalities due to drunken driving I think you’d see a pretty strong outcry.”
Both Davis and Hagwood said they thought most people’s problems with prescription drugs began innocuously and the victims were in no way bad people.
In fact the victims don’t seem to fit into any of the traditional stereotypes of people affected most by drugs.
The average age of the victims is 39 years old and most of them seemed to have children and families, and none of the deaths occurred in a party atmosphere.
The victims weren’t out-of-control youth looking for a thrill or loners nursing a habit in isolation.
Addressing that fact, Hagwood said he didn’t think “pharm parties,” where people grab random drugs from a bowl, were nearly as prevalent as they were portrayed to be in the media, and the public tended to grasp on to sensational aspects when first becoming aware of a problem.
Peay said he didn’t think prescription meds had reached the same level of popularity among youth as alcohol and marijuana but was still more in the hard drug category as opposed to youth party substance in general.
Hagwood and Peay said the problem was particularly disturbing because it wasn’t as simple as the traditionally accepted DARE narrative of drug use where stupid people and out-of-control maniacs seek out completely destructive substances and uncaringly consume them.
They argued that the people who shared or sold their prescription medications and the people accepting them didn’t think of themselves as being involved in a problem in anyway associated with the risks of the hard drug trade.
“I don’t think generally the communities look at people that sell prescription medication in the same light that they look at people dealing methamphetamine, and generally a lot of the people that will divert their prescription medication would probably never dream of dealing methamphetamine,” Hagwood said.
The PCSO officers also indicated the issue was hard for law enforcement to address because conviction of a dealer requires a witness.
With a drug like methamphetamine a suspect just has to have a certain amount of the drug or other indications he’s selling it to be charged as a dealer.
With prescription drugs it isn’t that easy because all the drugs are accounted for with legal prescriptions, so law enforcement has to be able to prove an individual illegal sale occurred.
This doesn’t stop the sheriff’s office from spending a lot of time on the issue, although much of it is spent fruitlessly in investigations of allegedly stolen medications.
Hagwood explained, “Some of the thefts and burglaries are probably legitimate where people are breaking into homes and stealing these narcotic pain medications, and probably an equal if not greater number of these reports are probably people who are selling their prescription medication.
“They run through their supply; in order to get a new supply ahead of schedule, they have to report it was stolen.”
The worst cases of prescription drug addiction can be shocking.
Hagwood and Peay described one of the overdose cases involved a man who had previously been a productive, high-functioning member of society who ended up committing many burglaries to feed his addiction.
They said the man also cut off a finger and toe and drove a nail through his hand to get more drugs from the emergency room.
Hagwood said the problem was particularly hard for authorities to tackle because it is so varied, with painkillers, anti-anxiety meds, anti-depressants and anti-psychotics all capable of being abused.
He also said a large cause of the problem was most people didn’t think taking these medications was as significant as drinking alcohol, because of the place prescription drugs occupy in our society.
“The American public is just being bombarded by the pharmaceutical industry to take a pill for any and everything that could conceivably be wrong with you and some stuff that you haven’t even thought of.”
Peay said most of the problems came from habitual use, but the current situation made it possible for someone to experience an accidental overdose simply by going to multiple doctors like a heart specialist, back doctor and general practitioner without telling each about the others and ending up with a lethal cocktail.
He added a diffused system of obtaining medications made this possible.
Peay gave an example: if Quincy Drug got three prescriptions that didn’t work together, the pharmacist would tell the patient. But people often get drugs from different doctors and fill the prescriptions at different pharmacies.
On the solution side, both PCSO experts agreed law enforcement had a role in the issue, but would not be able to solve it.
Peay said a system called CURES, controlled substance utilization review and evaluation system, could provide the next step in combating the problem.
California Attorney General Edmund Brown began the CURES program in September.
The system allows doctors, pharmacists and law enforcement to request information about someone with a suspected prescription drug problem who has been getting medications.
The hope is the program will allow public safety figures on all sides of the problem to identify when someone is “farming doctors” or traveling from town to town getting medications.
The program is relatively new at this point to doctors and law enforcement so there has been little feedback on its effectiveness so far in Plumas County, but Peay said the department had used it multiple times.
Hagwood thought this type of program would have to be expanded in the future and become a bigger part of addressing the problem.
“I don’t want the government monitoring me anymore than they already do, but to the extent that we’ve got such a problem with this abuse there needs to be some mechanism put in place that I think could at least bring some relief to it.”
He said the other side of the problem that had to be addressed was people’s misconception that prescription drugs didn’t pose any of the problems of illegal drugs.
“Being strung out on methadone or hydrocodone or oxycontin will leave you in just as much a mess as being strung out on heroine, cocaine or methamphetamine,” he emphasized.
Hagwood acknowledged the medical community was trying to help and many doctors were responsible and informed in their prescribing habits, but the public and other doctors still had a lot to learn.
He and Peay also agreed the lack of addiction treatment options in Plumas County made the problem even more difficult to address effectively.
Look for part two of our report on the prescription drug problem in next week’s newspaper.