In one of the news-feeds I receive from various medical organizations was the notice that the parents of a young women in Middletown, Ohio added as the cause of death in their young daughter’s obituary that she died of a heroin overdose. This heartbreaking disclosure is newsworthy because is is part of a growing movement to bring the curse of opioid addiction further out of the shadows, specifically to emphasize that all communities and all families are vulnerable to this societal and medical problem. One can only imagine the grief of this family and be grateful for their courageous and generous act. They hope to help prevent other deaths in this way. As an aside, I am reminded that the Journal of the American Medical Association used to list the cause of death of all physicians who had died. As a boy I used to read these notices every week. Frequent causes were suicide, medical complications of alcoholism– and if my memory serves me– drug overdose. These problems have not gone away and remain as occupational hazards for physicians. We should be so open today as these parents were as we physicians attempt to heal our brothers and sisters.
The notice stimulated me to look at the pattern of opioid drug prescription to Medicare patients in Ohio to test the hypothesis that prescription drug abuse is the forerunner if not the fellow traveler of heroin and other illegal drug use. Using the same protocols I describe for Kentucky and Indiana, I extracted from the Medicare Part-D database all Ohio providers who prescribed every listed individual opioid drug to more than 10 patients in the year 2013. The totals for this subset were 2,362,795 opioid prescriptions costing $66.3 million. That information is further summarized and discussed below. In summary, based on the size of its population, Middletown was not an obvious hot-spot for opioid prescription but it was the business home to a family practitioner who was the 10th highest prescriber in the state. Other apparent problem areas did emerge from the data including southern Ohio where the epidemic of prescription drug abuse was recognized early. Continue reading “Prescription Of Opioid Analgesics In Ohio– More Of The Same.”