Feb. 28--That prescription-drug abuse is rampant is not news to anyone in emergency medicine or law enforcement, especially in Ohio.
But a new study out of Nationwide Children's Hospital's Center for Injury Research and Policy aims to better quantify the problem and highlight trends that might help those combating drug abuse.
The study, published in today's American Journal of Emergency Medicine, estimates that almost 700,000 Americans went to emergency departments for drug-related poisoning in 2007 at a cost of almost $1.4 billion, 41 percent of which was paid by Medicare and Medicaid.
The researchers looked at data from a sampling of U.S. emergency departments and extrapolated to get a national estimate.
Dr. Gary Smith, who directs the Center for Injury Research and Policy, said he was surprised by the magnitude of the problem.
In the adult population, overdoses -- mostly of painkillers and psychotropic drugs -- were most common in those 35 to 54 years old and were three times higher in rural areas.
The discrepancy between urban and rural areas is not easy to explain, Smith said. In Ohio, "pill mills," where doctors dispense large amounts of painkillers, have been of particular concern in rural communities.
The study looked at both adults and children. Among children, those 5 or younger had the highest rate of unintentional poisonings. In those cases, kids are mostly getting into drugs intended for their older relatives or getting too much of something intended for children.
One of the main problems with children is that they can get into syrups that contain acetaminophen, said Dr. Leslie Mihalov, chief of emergency medicine at Children's. The syrups taste good to young children, who sometimes chug down a whole bottle if they're unsupervised, she said.
Parents and older relatives and friends can help protect kids from prescription drugs by making sure the medicines are kept out of reach and out of sight, Mihalov said.
"I think the biggest problem is, elderly people or people who don't have children in their home get those caps that are easier to open," she said.
Children sometimes find pills in purses, or the pills drop out of people's pockets, she said.
According to the national Drug Abuse Warning Network, emergency visits related to prescription-drug abuse doubled between 2004 and 2008, from 500,000 to 1million.
The issue has garnered a lot of national attention and has become a focus in Ohio.
In 2007, unintentional drug poisoning became the leading cause of injury death in Ohio, surpassing motor-vehicle crashes and suicide for the first time. That was a wake-up call for public-health, law-enforcement and government officials and others, said Christy Beeghly, administrator of the violence- and injury-prevention program at the Ohio Department of Health.
According to preliminary 2009 data from her office, at least 1,373 Ohioans died of overdoses, an average of four a day. Southern Ohio counties have the highest death rates.
A lot of work is being done on a statewide level, including recently introduced legislation that aims to combat the problem in several ways. Individual counties also are working to tackle prescription-drug abuse, but it is a problem that presents many challenges, Beeghly said.
One of those is making sure that the people who need painkillers don't face unfair obstacles, she said.
"It's a delicate balance. One of the things that's always been at the heart of it is we don't want to deny people who need the medication access to it."
mcrane@dispatch.com
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