Authorities are getting a snapshot of the pervasiveness of opioid-related prescriptions issued in St. Charles County, based on the initial reports from the prescription drug monitoring [PDMP] program now serving St. Louis and St. Charles counties, the city of St. Louis and at least 14 other state counties.
That snapshot shows some high numbers – but local health officials don’t know yet exactly what they mean.
St. Charles County ranked second in opioid “dispensation rates,” the amount of opioid prescriptions issued, among the counties participating in the PDMP. County residents were prescribed opioids at a rate of seven prescriptions for every 10 people in the county. That compares to nine prescriptions for every 10 people in Lincoln County, six prescriptions for every 10 people in St. Louis County, and nearly six prescriptions for every 10 people in the city of St. Louis. For all the counties and cities in the PDMP, the rate was above six opioid prescriptions per 10 people.
Last September, the St. Charles County Council agreed to join the PDMP to track the number of prescriptions issued by health care professionals to try to guard against over prescribing opioid-related drugs such as painkillers. The effort expanded to include other counties. In July, Gov. Eric Greitens ordered the creation of a statewide PDMP.
Authorities view a PDMP as critical in helping to deal with what they are calling a “heroin epidemic” in Missouri. The catalyst for that epidemic are drugs, such as OxyContin and Vicodin, that are prescribed to treat pain but can lead to addiction and heroin use. Heroin often is more potent and cheaper than prescription opioids.
Hope Woodson, the county’s director of public health, said the idea was to recruit dentists, pharmacists and physicians. There are now more than 3,000 dentists, pharmacists and physicians participating in the PDMP. Woodson said medical groups and professionals have been very receptive to participating in the PDMP.
“There has been no push-back at all,” she said. “We didn’t know what to expect because we’ve never been in any position to get any data. At first I thought, ‘oh my goodness, we’re way up there’ [in regard to the dispensation rates]. But thinking about what we were looking at, we don’t know the exact reason behind it.
Woodson said the county could have more residents seeking treatments of particular ailments.
“We do have a high population that has insurance. We do have more residents who are going to doctors, who utilizing prescriptions, who are seeking out treatment. That could well be a nonthreatening reason why the number is higher.”
“I tried to put the most positive spin I could on it but the truth [is] told in the numbers; for whatever reason that’s behind it, we do prescribe and receive a lot of opioids within St. Charles County,” Woodson said.
She added that the initial data may provide a baseline for future comparisons.
The high amount of prescriptions worries authorities because of the number of opioid-related deaths and overdoses in recent years. Woodson said heroin laced with Fentanyl, a synthetic and extremely potent synthetic opiate, is causing a higher incidence of fatal overdoses.
But having a large population using a large amount opioid drugs “doesn’t mean they are necessarily taking them improperly,” Woodson said. Still, she said,it’s “something to begin to look at.”
Woodson said authorities are not interested in why and what individuals are taking.
“We’re just looking at the overall rates and what we can do to combat [overdoses and death] and what we can do to combat if [people] are using [prescriptions] inappropriately.”
Brandon Costerison, a public awareness specialist with the National Council on Alcoholism & Drug Abuse – St. Louis [NCADA], said he also is unsure what the prescription rates mean. For example, data from the Centers for Disease Control and Prevention suggest that the number of opioid-related prescriptions fell in Missouri in previous years, he said. Still, he said the local numbers are “concerning.”
“I still think it should be concerning, opioids are very powerful, very addictive medications,” Costerison said. “So given that there have been enough prescriptions written for 70 percent of people in St. Charles County to have one over a three-month period – people in St. Charles County aren’t that clumsy and there’s not that much back pain. That’s really concerning.”