Opioid overdose deaths remain a huge concern in poverty-stricken Eastern Kentucky counties; Boston Globe takes note

Drug overdoses from opioid use remain a concern in Eastern Kentucky, especially in poverty-stricken regions where coal mines have shuttered, Brian MacQaurrie reports for The Boston Globe. In 2014 Kentucky had 1,087 deaths from opioid overdoses, more than from traffic mishaps.

In Bell County (Wikipedia map) nearly two-thirds of adults “do not have jobs, and
addiction to opioid painkillers has metastasized,” MacQuarrie writes.
“Miners often turned to painkillers after injuries, and many of their
children became dependent on opioids stashed as close as the medicine
cabinet. Nearly everyone here knows someone who has become addicted or
died from opioids.”

“The opioid death rate in 2013 was
93.2 per 100,000 people in Bell County, nearly double that of any other
Kentucky county,” MacQuarrie writes. “But C. Frank Rapier, who directs a
federal task force attacking the epidemic in Appalachia, said the
devastation in Bell County also reflects what is happening in
neighboring counties, where federal officials believe opioid deaths have
been grossly underreported.”

“The death rate in Bell County dropped in 2014, but the figure remains troublingly high,” MacQuarrie writes. “Many children are raised by grandparents, some mothers prostitute their daughters, and hospice providers lock medications in theft-proof safes at the homes of the soon-to-be deceased. Nancy Hale, who leads the drug-prevention efforts in the region, told him, “We’ve lost a whole generation of people who would have been paying taxes, and buying homes, and contributing to society.”

Former state trooper and Pineville native Micky Hatmaker said the blame mostly falls on big pharmaceutical companies for “aggressively marketing painkillers and on unscrupulous doctors and pharmacists who dispense them,” MacQuarrie writes. Hatmaker told him,

“This thing took over Appalachia like a cancer.” Purdue Pharma paid a federal-court settlement of hundreds of millions of dollars in 2007 for its promotion of Oxycontin, and Kentucky has its own lawsuit pending.

In an attempt to
eliminate pill mills, Kentucky in 2012 became the first state “to enact a
strict mandate that physicians check a patient’s drug history before
writing new prescriptions,” MacQuarrie writes. As part of the plan, Attorney General Jack Conway has been “aggressively targeting doctors whose
practices are designed to profit from addiction.” As a result,
“prescriptions of oxycodone, a powerful opioid, have dropped 10.5
percent. Prescriptions for hydrocodone—also used to relieve pain—have
fallen 11 percent.”

Judges have handed down harsher sentences for owners of pain clinics, including a 14-year sentence given in June to the owner of two clinics, MacQuarrie writes. Another area of success “has been Operation UNITE, a large nonprofit group that has carried a drug-prevention message to tens of thousands of students in venues from classrooms to archery camps. More than 3,700 people have received $5,000 vouchers from the group for substance-abuse treatment. And police detectives working with Operation UNITE have removed $12.3 million of drugs from the street since 2003.” Operation UNITE has received much federal funding, thanks to House Appropriations Committee Chairman Harold “Hal” Rogers, who represents most of Eastern Kentucky.

The Boston Globe did its story because Massachusetts also faces an opioid overdose epidemic, with 1,256 deaths from opioid overdoses in 2014. That has led to a shared bond between the two states, with Senate Majority Leader Mitch McConnell (R-Ky.) and Sen. Edward J. Markey
(D-Mass.) joining forces to ask for a surgeon general’s report on the crisis and detailed answers
on how the Department of Health and Human Services will measure
progress on opioid deaths and addiction. (Read more)

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