7.8 million opioid prescriptions last year: Is Georgia overdosing?

Since it opened in February, the narcotics treatment center Zac Talbott co-owns in North Georgia has been booming, admitting more than 250 people with addictions to painkillers and heroin amid a nationwide opioid overdose epidemic that is killing thousands of people each year.

For Talbott, the work is personal. He started using pain pills for minor back pain when he was in graduate school. That habit spiraled into an addiction, and he started buying pills on the street. Talbott eventually got help and has been recovering for several years.

So he was dismayed when he learned just how many pain medication prescriptions were issued in Georgia last year: a whopping 7.8 million, equivalent to more than one prescription for every single adult in the Peach State.

“Ridiculous,” said Talbott, the program director for Counseling Solutions of Chatsworth. “Most of our patients — they got started on pain pills… from their family doctor.”

Even at that high per capita rate of .77, Georgia ranked only 20th among states in 2015. Alabama topped the list last year with 1.2; followed by Tennessee, 1.18; and West Virginia, 1.13.

Chad Conard doesn’t know what to think about the millions of painkiller prescriptions issued in his home state. But the North Georgia resident does know he is doing well on the pain medication he is taking for a back injury he suffered on the job eight years ago. So far, he has had four back surgeries. And without the two Norco pills he takes each day, Conard said, he wouldn’t be able to play with his 3-year-old grandson.

“I do this so I can walk and work for my family. The last thing I want is to try to draw disability or something like that,” he said. “Without it I can barely get out of bed.”

Opioids have a wealthy, powerful lobby

Opioids, which can also help patients suffering from fatal illnesses, are contributing to an overdose crisis that killed about a thousand people a year in Georgia between 2006 and 2014. Those deaths involved drugs of all kinds, though most were tied to heroin and prescription painkillers such as fentanyl, the powerful synthetic opioid that killed Prince in April.

These findings are part of a joint investigation by the Associated Press and the Center for Public Integrity called “Politics of Pain: A Decade of Opioid Lobbying.” The report is based on data obtained from IMS Health, a health-care information company; the U.S. Centers for Disease Control and Prevention; the U.S. Census Bureau; and the National Institute on Money in State Politics.

Among the report’s other findings:

  • Last year, 227 million opioid prescriptions were issued in the U.S., enough to give pain pills to nine out of every 10 adults nationwide. Meanwhile, opioid sales reached $9.6 billion last year.
  • Drug overdoses — mostly connected to prescription painkillers and heroin — killed 356,000 people in the U.S. between 2006 and 2014.
  • Members of the Pain Care Forum, a coalition of drugmakers that produce painkillers and allied advocacy groups, have spent more than $880 million nationwide on campaign contributions and lobbying over the past decade as they worked to influence policies. In contrast, groups pushing for limits on painkiller prescriptions spent about $4 million.

The investigation highlights efforts by Pain Care Forum members to help kill or weaken state measures aimed at tightening opioid prescriptions, though none of the those examples was in Georgia. In Georgia, forum members contributed $1.2 million to state political candidates and parties over the last decade.

Pat Strickland of Gwinnett County partly blames the over-prescription of painkillers for the death of her daughter, Stephanie Futrell, at 33. Futrell started abusing a pain medication called Lortab when she was in her 20s. Her addiction led her down a slippery path to heroin.

On the day after Thanksgiving 2014, Futrell died from an overdose of heroin mixed with fentanyl, a pain reliever that is as much as 50 times more powerful than heroin. The family was surprised by Futrell’s years-long addiction, particularly since she was among those who sadly watched as her little sister, Rebecca, fought a desperate – an ultimately winning — battle against an addiction to a drug that doctors prescribed her for kidney stones: fentanyl.

“All you have to do is say, ‘But I hurt,’ and they give you a pain prescription,” said Strickland, a legal assistant who is now raising Futrell’s two young sons. “There just has to be a better way.”

‘Lines out the door to get prescriptions’

Mike Morrison, a Gwinnett assistant district attorney, prosecuted the man who supplied the drugs that killed Futrell and two others. All three plus their dealer were addicted to pain pills. Some of the roots of the problem are clear to Morrison.

“We had a number of these pain clinics pop up in Gwinnett. There would be lines out the door to get prescriptions for opiates,” he said, adding that phenomenon has faded amid enforcement. “And from that addiction, it was cheaper to go to heroin.”

Doctors and dentists in Georgia said they are fighting the opioid epidemic through educational campaigns and by providing patients with safe places to dispose of unneeded or expired medications. They are also using a state database that helps identify “doctor-shopping” patients. And they are helping police get more supplies of a life-saving drug called naloxone, which reverses overdoses.

Dr. P. Tennent Slack, who practices in Gainesville and who helps lead a Medical Association of Georgia Foundation campaign aimed at stopping prescription drug abuse, has Conard among his patients. There are many ways to treat pain other than through opioids, Slack said, including counseling and surgery.

But pain pills, he said, can help patients “get through the day and do the stuff they need to do.”

Dr. Ben Jernigan Jr., president of the Georgia Dental Association, said: “The root of the problem is far deeper than prescribing pain killers. Patients have a responsibility to use opioid painkillers only as prescribed and to keep their unused medications from getting into the wrong hands.”

Forum members gave $89,900 to Gov. Deal

Drugmakers like New York-based Pfizer — which manufactures fentanyl and has made $614,852 in campaign contributions in Georgia over the last decade — said they are educating people how to properly use pain medication and advocating for new formulations of their drugs that make them harder to abuse.

“Pfizer is committed to combatting prescription drug abuse while ensuring that patients who need it receive appropriate and adequate treatment for pain,” Pfizer spokeswoman Sharon Castillo said in a statement.

Pfizer, Castillo added, has not worked with any of the Pain Care Forum’s lobbyists in Georgia and stopped paying membership fees to the group in 2012. Further, she said, none of the company’s political contributions in Georgia was related to the forum’s efforts.

Among state candidates and political parties in Georgia, Republican Gov. Nathan Deal was the top recipient of political contributions from Pain Care Forum members over the past decade at $89,900, followed by the Georgia Republican Party, $76,130, and the Georgia Democratic Party, $57,300.

A spokeswoman for Deal pointed out that several of the governor’s donors are companies that market different life-saving drugs and devices, including vaccines and medication focused on tumors. She also referred to the expansion of special courts in Georgia that deal with nonviolent offenders, many of whom are drug users. Further, she highlighted how Deal signed a 2013 measure requiring pain clinics to be licensed by the Georgia Composite Medical Board.

Georgia Democratic Party spokesman Michael Smith said expanding Medicaid in the state would help by giving drug addicts access to affordable recovery services. Although the federal government would cover most of the cost of expansion, Deal has rejected it, saying the state can’t afford to make Medicaid any bigger than it is.

‘Designed to put our foot on the brake’

In April, Deal signed a bill that prohibits the state from licensing new narcotic treatment programs for a year. Unanimously approved by the Legislature, Senate Bill 402 also established a panel to study the state’s licensing program and the effectiveness of addiction treatments that don’t rely on narcotics such as methadone.

Sponsored by Republican state Sen. Jeff Mullis of Chickamauga, the bill arose out of concern about a growing number of narcotic treatment programs in the state. There are now 67 in Georgia, federal records show.

Jonathan Connell, president of Opioid Treatment Providers of Georgia, supports the measure.

“What the moratorium is designed to do is just to put our foot on the brake,” said Connell, who operates three narcotic treatment programs in Southwest Georgia. “We want to increase the access to care. That is fundamental. But we want to make sure it is done in an appropriate manner.”

Talbott, who co-owns the addiction treatment center in Chatsworth, opposes the measure.

“We are in an opioid addiction and overdose epidemic and you are going to stop new facilities from coming into the state that address that very epidemic?” he said. “It is unconscionable.”