November 25, 2014

Elyria
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Is the United States a nation of pain?

MYRTLE BEACH, S.C. — People in the United States are living in a world of pain and they are popping pills at an alarming rate to cope with it. The amount of five major painkillers sold at retail establishments rose 88 percent between 1997 and 2005, according to an Associated Press analysis of statistics from the Drug Enforcement Administration.

More than 200,000 pounds of codeine, morphine, oxycodone, hydrocodone and meperidine were purchased at retail stores during the most recent year represented in the data. That total is enough to give more than 300 milligrams of painkillers to every person in the country.

AP
The use of oxycodone increased sixfold in the U.S. between 1997 and 2005.

Oxycodone, the chemical used in OxyContin, is responsible for most of the increase. Oxycodone use jumped nearly six-fold between 1997 and 2005. The drug gained notoriety as “hillbilly heroin,” often bought and sold illegally in Appalachia. But its highest rates of sale now occur in places such as suburban St. Louis; Columbus, Ohio; and Fort Lauderdale, Fla.

The world of pain extends beyond big cities and involves more than oxycodone.

In Appalachia, retail sales of hydrocodone — sold mostly as Vicodin — are the highest in the nation. Nine of the 10 areas with the highest per-capita sales are in mostly rural parts of West Virginia, Kentucky or Tennessee.

Suburbs are not immune to the explosion.

While retail sales of codeine have fallen by one-quarter since 1997, some of the highest rates of sales are in communities around Kansas City, Mo., and Nashville, Tenn., and on New York’s Long Island.

The DEA figures analyzed by the AP include nationwide sales and distribution of drugs by hospitals, retail pharmacies, doctors and teaching institutions. Federal investigators study the same data trying to identify illegal prescription patterns.

Retired Staff Sgt. James Fer-nandez, 54, of Fredericksburg, Va., survived two helicopter crashes and Gulf War Syndrome over 20 years in the Marine Corps. He remains disabled from his service-related injuries and takes the equivalent of nine painkillers containing oxycodone every day.

“It’s made a difference,” he said. “I still have bad days, but it’s under control.”

Such stories should hearten longtime advocates of wider painkiller use, such as Russell Portenoy, head of New York’s Beth Israel pain management department. But they have not.

“I’m concerned and many people are concerned,” he said, “that the pendulum is swinging too far back.”

Perhaps no place illustrates the trends and consequences better than Myrtle Beach, a sprawling community of strip malls, hotels and bars perched along a 60-mile strip of sand on the Atlantic Ocean. The metro area, which includes three counties, is home to 350,000 people but sees more than 14 million tourists annually, drawn to its warm water, golf courses and shopping.

During the eight-year period reflected in government figures, oxycodone distribution in-creased 800 percent in the area of Myrtle Beach, partly due to a campaign by Purdue Pharma-ceuticals of Stamford, Conn. The privately held company has pleaded guilty to lying to patients, physicians and federal regulators about the addictive nature of their drug.

Use of other drugs soared in the area, too: Hydrocodone use increased 217 percent;  and morphine distribution went up 180 percent.