Opioid prescription totals falling in Georgia amid deadly epidemic

Fatal opioid-related overdoses also shrinking in Peach State
Drugs such as morphine, fentanyl, and oxycodone are such powerful analgesics because they so effectively block pain signals by acting directly on the brain. OxyContin, in 80 mg pills, in a 2013 file image. (Liz O. Baylen/Los Angeles Times/TNS)

Combined ShapeCaption
Drugs such as morphine, fentanyl, and oxycodone are such powerful analgesics because they so effectively block pain signals by acting directly on the brain. OxyContin, in 80 mg pills, in a 2013 file image. (Liz O. Baylen/Los Angeles Times/TNS)

Georgia is seeing hopeful signs in its battle against deadly opioid abuse.

New figures released by the state's Public Health Department show the numbers of prescriptions for opioids — such as hydrocodone and oxycodone — dropped by 13 percent between 2016 and 2018.

During the same timeframe, another statistic that could indicate addiction — the number of patients who got such prescriptions from five or more doctors, dispensed at five or more pharmacies — fell by more than half. That number is now 12.2 people per 100,000, down from 30.8.

Opioid-related overdose deaths of Georgia residents dropped by 12 percent between 2017 and 2018, falling from 996 to 873, according to preliminary numbers the state agency released to The Atlanta Journal-Constitution.

Experts say many factors may be behind the reductions: increasing publicity surrounding the health crisis, three-year-old federal guidelines for opioid dosages and the expansion of prevention and treatment programs.

They also pointed to a 2017 state law that requires Georgia doctors and dentists to check a database to see what prescriptions patients have recently filled before prescribing them opioids and other drugs. Called the Prescription Drug Monitoring Program, the database aids doctors in identifying patients who already have been prescribed dangerous amounts or combinations of drugs.

“A lot of people do become addicted from opioid prescriptions,” said Laura Edison, a medical epidemiologist at the state’s Public Health Department. “And we also know that a lot of opioid prescriptions get diverted and are sold illicitly. So getting these drugs off the street and keeping people who have alternatives to opioids from using opioids to manage their pain is going to help prevent addiction and overdose.”

Driven by opioids, drug overdoses killed a record 70,237 Americans across the nation in 2017. The total dropped by 2 percent to 68,557 last year.

One estimate from last year said, over the preceding 17 years, the nationwide economic toll of the crisis topped $1 trillion. That includes the cost of lost wages, productivity and tax revenue, as well as money spent on health care, social services, education and public safety, according to the Altarum Institute, a nonprofit health systems research group. Such costs have prompted hundreds of cities and counties in Georgia and across the nation to sue drug manufacturers and distributors.

Dr. Justine Welsh, who directs Emory Healthcare’s addiction services, praised Georgia’s results. But she also wants to see a bigger reduction in the percentage of days patients have overlapping prescriptions for opioids and benzodiazepines, or sedatives. That number was 13.1 last year, down from 15.1 in 2016. Mixing those types of drugs increases the risk of respiratory depression and overdose, she said.

“There was a decrease in that, which is fantastic,” said Welsh, an addiction psychiatrist. “I would still like to see that further decreased.”

Jim Langford, executive director of the Georgia Prevention Project, an Atlanta-based drug abuse prevention group, also hailed the state’s progress. But he pointed to how Georgians who are 55 and older accounted for more than half of all opioid prescriptions last year.

“Those older patients are not as careful with locking up their drugs as they should be and that is a big deal,” he said. “These younger kids are getting these drugs out of parents’ or grandparents’ medicine cabinets.”

State health officials also reported the percentage of patients who received doses of opioids above federal guidelines dropped from 7.9 to 6.2 between 2017 and 2018. Issued by the Centers for Disease Control and Prevention in 2016, the guidelines have drawn fire from chronic pain patients who say they are being used to block them from getting the medication they legitimately need. Dozens demonstrated outside the CDC's Atlanta offices in June. Two months before that, the CDC issued a statement advising against misapplying the guidelines.

"We don't live in a one-size-fits-all health care world, and my illness is different from your illness," said Claudia Merandi, a Rhode Island resident who founded the Don't Punish Pain Rally Organization and has taken oxycodone to help her cope with Crohn's disease. "What I need is what my body needs, and what you need is what your body needs."

Edison, the medical epidemiologist, said public health officials are pushing “to ensure that patients who legitimately need opioids still have access to them.”

Top 10 opioids, by number of prescriptions written, in Georgia*

1. Hydrocodone SA, 2,633,956

2. Oxycodone SA, 1,748,749

3. Tramadol SA, 1,597,438

4. Codeine, 430,621

5. Buprenorphine, 371,036

6. Morphine LA, 195,548

7. Fentanyl LA, 127,338

8. Morphine SA, 89,208

9. Methadone, 88,995

10. Oxycodone LA, 83,633

*Statistics from 2018

SA: Short Acting

LA: Long Acting

Opioid prescriptions in Georgia

2016: 8,589,707

2017: 8,001,050

2018: 7,487,527

% Change 2016-2018: 13

Opioid patients in Georgia

2016: 2,331,269

2017: 2,177,640

2018: 2,018,390

% Change 2016-2018: 13

Opioid-related Overdose Deaths of Georgia Residents

2016: 904

2017: 996

2018: 873

Source: Georgia Public Health Department

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