Painkiller sales take off in Georgia, other states

From New York’s Staten Island to Santa Fe, N.M., Drug Enforcement Administration figures show surges from 2000 to 2010 in the distribution of oxycodone, the key ingredient in OxyContin, Percocet and Percodan.

In Georgia, per capita sales more than tripled. Some states, including neighboring Florida and Tennessee, experienced even more dramatic increases.

The distribution of hydrocodone, the key ingredient in Vicodin, Norco and Lortab, is also rising. Georgia’s per capita sales more than doubled, but that didn’t match the pace in Appalachia, the original epicenter of the painkiller epidemic, and in the Midwest.

The increases have coincided with a wave of overdose deaths, pharmacy robberies and other problems from Utah to Florida. Opioid pain relievers, which include oxycodone and hydrocodone, caused 14,800 overdose deaths in 2008 alone, and the death toll is rising, the Centers for Disease Control and Prevention says.

In Georgia, overdose deaths have risen as much as 10 percent in some recent years, and the vast majority involve prescription drugs, according to the Georgia Bureau of Investigation.

Nationwide, pharmacies dispensed the equivalent of 69 tons of pure oxycodone and 42 tons of pure hydrocodone in 2010, the last year for which statistics are available. That’s enough to give 40 5-mg Percocets and 24 5-mg Vicodins to every person in the United States.

The increase is partly due to the aging population and a greater willingness by doctors to treat pain, said Gregory Bunt, medical director at New York’s Daytop Village chain of drug treatment clinics.

Metro Atlanta is part of that aging trend. The number of people 65 and older grew by 44 percent from 2000 to 2010, according to census figures. Nearly half a million seniors live in the 28-county metropolitan statistical area, an increase of 145,000 over the past decade.

Sales are also driven by addiction, as users become dependent on painkillers and begin “doctor shopping” to keep prescriptions coming, experts said.

Gil Kerlikowske, director of the Office of National Drug Control Policy, told Congress in March that prescription medicines “can be just as dangerous and deadly as illicit substances when misused or abused.”

In many parts of Georgia, addicts can turn to pain-management clinics not affiliated with any hospital or established medical practice. The number of those clinics has surged from fewer than a dozen to more than 90, Rick Allen, director of the Georgia Drugs and Narcotics Agency, told The Atlanta Journal-Constitution last year.

Many are northwest of Atlanta along I-75 — a stretch known among law enforcement officials as the “Oxy Express” because of drug seekers who stream from Kentucky, Tennessee, West Virginia and Ohio on their way to pill mills in Florida.

Last year brought high-profile arrests and indictments in Georgia, illustrating how prescription forgery rings, counterfeit prescription pushers and illicit pain clinics have sprung up. Some clinic operators reportedly moved to Georgia after federal agents shut down their Florida operations.

Compared to many states, Georgia has been slow to monitor and regulate the sale of prescription painkillers.

Forty states have statewide databases aimed at flagging patients who try to obtain multiple prescriptions. Last year Georgia lawmakers approved a program, but the system won’t be online until next year.

During the legislative session just ended, state Attorney General Sam Olens urged lawmakers to tighten regulation of pill mills. That bill died on the final day of the session.

Opioids like hydrocodone and oxycodone can release intense feelings of well-being. Some abusers swallow the pills; others crush them, then smoke, snort or inject the powder.

The problem has its roots in two disparate parts of the country — Appalachia and affluent suburbs, said Pete Jackson, president of Advocates for the Reform of Prescription Opioids.

“Now it’s spreading from those two poles,” Jackson said.

In 2000, oxycodone sales were centered in coal-mining areas of West Virginia and eastern Kentucky, with high concentrations of back problems and other chronic pain.

By 2010, the strongest oxycodone sales had overtaken most of Tennessee and Kentucky, and stretched as far north as Columbus, Ohio, and as far south as Macon.

In 2006, only 20 states had prescription drug monitoring programs aimed at tracking patients. Now twice that many do, but many aren’t linked together, so abusers can simply go to another state when they’re flagged in one state’s system.

Staff writer Victoria Loe Hicks and Chris Hawley of The Associated Press contributed to this article.

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