Painkiller abuse not a campus problem

Painkiller overdose ER visits in the Twin Cities have more than doubled from 2005 to 2009.

Kyle Potter

While prescription painkiller abuse has increased nationwide in recent years, University of Minnesota officials say the problem hasnâÄôt migrated to clinics on campus.

Distribution and nonmedical use of prescription painkillers is prohibited by federal law, but off-the-label abuse has grown into a nationwide epidemic.

The most troubling drugs are opioids, or narcotics âÄî potent pain relievers that can wreak havoc if abused.

On April 20, President Barack Obama unveiled a five-prong plan to counter prescription drug abuse, “the nationâÄôs fastest growing drug problem.”

But University doctors, pharmacists and administrators said they havenâÄôt seen signs of the epidemic near campus.

“Usually, what trips it is if we start seeing an increase in incidents here. To my knowledge, we havenâÄôt really seen that,” said Dave Golden, director of public health for Boynton Health Service.

Across the country, deaths due to opioid medication overdose grew steadily from 1999 to 2007 âÄî from about 3,000 deaths in 1999 to almost 12,000 eight years later, according to the Centers for Disease Control and PreventionâÄôs National Vital Statistics System.

That rise has been mirrored in the Twin Cities since 2000, said Carol Falkowski, drug abuse strategy officer for the Minnesota Department of Human Services. Emergency department visits for painkiller overdose more than doubled from 2005 to 2009, according to a DHS report.

Stephen Cain, BoyntonâÄôs pharmacy supervisor, said the bottles the pharmacy fills with opioid painkillers hardly count toward its total number of prescriptions.

“The amount of narcotics we dispense isnâÄôt significant [enough] that weâÄôd be worried about overdosing,” Cain said.

The basics of narcotic painkillers

Chemicals in opioid painkillers like oxycodone, hydrocodone and methadone are sold in pills with more familiar names: OxyContin, Percocet, Lortab and Vicodin.

Chemicals in the pills bind to opioid receptors in the brain to block perception of pain. Many recreational users have sought them out because of their similarity to heroin, another opioid.

Overuse or misuse of the drugs can have disastrous effects, said Dr. Miles Belgrade, medical director of Fairview Pain Management Center. Excessive amounts hinder respiratory function, which, if left unchecked, can cause death.

Drugs that contain opioids can exacerbate respiratory problems in people with sleep apnea and can decrease testosterone production in men, Belgrade said. In certain cases, opioids can actually increase perception of pain.

“The reason why people may tend to overdose [on these painkillers] is because theyâÄôre more available and theyâÄôre legitimate,” Belgrade said.

The pills can also be highly addictive, especially in people with risk factors for addiction or who have a family history of addiction, he said.

There is little data available on prescription drug abuse at the University.

According to BoyntonâÄôs 2010 College Student Health Survey, 6.5 percent of students reported they had used another personâÄôs prescription within the last year. That percentage includes other medications like antidepressants and Adderall.

In a 2003 survey by the University of Michigan Substance Abuse Research Center at an undisclosed, “large Midwestern university,” 10.1 percent of male students and 8.7 percent of female students reported illicit use of painkillers in the preceding year.

More than 50 percent of those said they got the pills from a peer.

Prescribing practices

Prescriptions forged or altered by drug-hungry patients were commonplace when Stephen Cain worked at a pharmacy in San Diego.

Since coming to Boynton, he said someone will edit a handwritten prescription to get more pills “once every five years.”

Cain said the majority of the narcotic prescriptions are for Vicodin, a drug commonly prescribed after wisdom tooth removal. Boynton rarely fills a prescription for a more powerful pill like Percocet, Cain said.

Most prescriptions for painkillers at Boynton are for 12 to 20 pills, which Cain said is below the norm for most pharmacies. Each bottle has a sticker warning that sharing its contents is prohibited by federal law.

Nationally, prescriptions of opioid painkillers increased almost threefold from 1991 to 2009, according to the National Institutes of Health. Boynton is careful about all prescriptions, whether for opioids or not, Cain said.

“We donâÄôt have a problem because weâÄôre pretty vigilant.”

The UniversityâÄôs School of Dentistry âÄî which doubles as a clinic âÄî can prescribe narcotic painkillers after surgery if needed, associate professor and oral surgeon Deepak Kademani said.

A prescription depends on the procedure and the patientâÄôs medical history, but Kademani said itâÄôs unlikely a patient of a routine surgery like wisdom tooth extraction would receive narcotic painkillers.

While going through his medical and dental education, Kademani learned to identify and deal with patients with substance abuse issues. In his three years on campus, where the clinic sees few students, he said he hasnâÄôt noticed any particular problems with abuse or distribution of prescription painkillers.

“It hasnâÄôt really come to my attention that itâÄôs a significant issue here at the University,” he said.