The World Health Organization estimates that about 5.6 percent of the global population, or 275 million people, used drugs at least once in 2016. About 27 million people suffered from opioid use disorder, with an increasing proportion using prescription opioids. The United States specifically has seen the effects of the opioid crisis up close and personal. According to the United Nations 2017 Drug Report, over 12 million people in the United States misused prescription opioids.
Some states in particular have been hit especially hard by the opioid crisis that has matured in the country. Many states in the midwest and the Appalachian region have seen just how traumatic this epidemic can be. Oklahoma is one state that has a major prescription drug problem, as they are highly available.
Prescription rates in Oklahoma are much higher compared to the national average. The availability of these prescription painkillers is leading to higher usage and more deaths in the state. In an effort to combat these high prescription rates, the state has put together some legislation that aims to make it more difficult for citizens to misuse prescription pills.
Prescription Drugs in Oklahoma
While drugs, especially opioids, across the country have become an increasingly severe problem, Oklahoma is one state that has seen the powerful effects prescription drugs can have. In the last couple years, the opioid death rate and prescription rate in Oklahoma has actually declined. However, it is still a major issue that the state is facing.
According to the National Institute on Drug Abuse, in 2016, there were 444 opioid-related deaths with 322 of them coming specifically from prescription opioids. However, from 2011 to 2015, prescription drugs caused the death of over 2500 people, killing an average of over 500 people annually.
In 2017, Oklahoma had a prescription rate of 88.1 prescriptions per 100 people, the sixth highest in the nation behind Alabama, Arkansas, Tennessee, Mississippi, and Louisiana. While the number is still abnormally high, when you compare it to the 101.7 prescription rate from 2015, progress is being made.
The counties that have the highest prescription rates across the state include Harmon, Carter, Murray and Tulsa. But, 45 out of Oklahoma’s 77 counties had a prescription rate higher than the national average.
The state has an obvious problem with prescription opioids. However, Oklahoma has recognized and acknowledged these issues and, in recent years, has tried to implement legislation that will reduce the circulation of prescription drugs, leading to less availability and deaths from prescription opioids.
Over the past couple of years, the number of prescriptions and the number of deaths associated with prescription drugs have slightly declined, perhaps this is because of the new legislation or maybe it is due to other reasons. Regardless the problem has been improving slowly.
While the state has seen progress being made over the past few years, there is still a lot of steps that need to be taken in order to neutralize the threat that prescription drugs have on the state. Still, the measures that Oklahoma has taken provide a good foundation to build on, and there is evidence that the laws they have passed already in regards to prescription drugs may be having a major effect on the issue.
Prescription Law Changes
Many states are now following in the steps of the federal government in creating laws aimed at minimizing the impact that opioids and prescription drugs have on Americans. Oklahoma is one state that has been doing this for the past few years, as the problem began to grow more prominent in the late-2000s and 2010s. The state has passed many laws in the past and recently which have contributed to the state’s decline in prescription drug rates and deaths.
Oklahoma Opioid Prescribing Guidelines
Oklahoma first created opioid prescribing guidelines in 2013 and was updated in additional materials in 2017. In the background portion to the guidelines, the state acknowledged the severe effects that prescription drugs have had on the state.
“Prescription painkillers (opioids) are now the most common class of drug involved in overdose deaths in Oklahoma,” the document said. “In a 2010 National Survey on Drug Use and Health report, Oklahoma led the nation in nonmedical use of painkillers, with more than 8% of the population age 12 and older abusing/misusing painkillers.”
The updated guidelines include measures such as health care providers being required to seek out non-pharmacological therapies or non-opioid pain medications and that opioid should only be used when the severity of the pain warrants their usage or long-acting and extended-release opioids should not prescribed for acute pain. Other aspects of the guidelines include:
- Avoid prescriptions of opioids when a patient is currently taking benzodiazepines or other opiods
- Patients should be counseled on how to store medications and to never share them with others
- A comprehensive evaluation should be performed before initiating opioid treatment for chronic pain
- Opioid treatment should be tapered or gradually discontinued if adverse effects outweigh the benefits.
Senate Bill 1446
Oklahoma Senate Bill 1446 was first signed into law in May but did not take effect until November. The law was written specifically to attack the problem of too many opioids in circulation in the state.
The purpose of Oklahoma’s SB1446 is to place limits on the number of opioid pills that physicians can prescribe. Limiting this is one of the first steps to curbing potential opioid misuse. Specifically, physicians are now only able to prescribe a week’s worth of opioid drugs to manage acute pain and must limit the dosage to the lowest effective dose.
Also under the new bill, before renewing a prescription, law now requires a consultation with the patient to ensure that the patient needs the prescription and that the patient does not present a risk for abuse or addiction. If the patient requires treatment with opioids that extends beyond three months the doctor and the patient must agree to regular monitoring.
As is the case with a lot of opioid and prescription drug reform legislation, the bill passed through the state house and senate garnering support from both sides of the aisle.
Despite the swift passage of the law, some believe that there are some problems with the way the law was written. According to the Oklahoman Editorial Board, there is some “fuzzy language [that] has led some doctors, wary of falling outside the law, to begin seeing fewer patients. It also has some pain patients concerned that they will lose access to their medications.”
However, the new law will be closely monitored and is likely to be fixed if problems occur.
House Bill 1948
In 2015, Oklahoma’s governor Mary Fallin signed House Bill 1948 into law. Similar to SB1446, HB1948 looks at the prescribing laws in the state and places limits on when and how controlled substances can be manufactured, distributed, dispensed and prescribed.
Under the law, substances were to be denied to people who have been found or pleaded guilty to a misdemeanor relating to a controlled substance or have a felony in any state. Another measure included in the bill said that an individual was to be denied controlled substances if they have been abusing or excessively using drugs in the past five years.
Some other highlights of the bill include penalizing prescribers who have:
- Prescribed or dispensed a controlled substance from schedules other than those specified in his or her state or federal registration
- Prescribed, sold or administered any controlled substance for an immediate family member, or themselves unless in the case of a medical emergency
Anti-Drug Diversion Act
Passed to deter abuse of prescription and other drugs, the Anti-Drug Diversion Act causes medical providers to notify the Oklahoma Bureau of Narcotics and Dangerous Drugs Control within 24 hours of dispensing Schedule II, III, IV, and V controlled substances. The notification is supposed to provide detailed identifying information about the recipient and substance being used. Failure to notify the bureau can result in jail time and if provided false information, a dispenser can be charged with a misdemeanor and be subjected to jail time and a fine.
Prescription Monitoring Program
Authorized under state law, the Prescription Monitoring Program was established to collect information related to drug prescriptions. The PMP provides checks on a patient’s need for controlled substances. Specifically, if 180 days have passed since previous access to opiates, synthetic opiates, semisynthetic opiates, benzodiazepines or carisoprodol, the medical or administrative staff shall be required to assess the necessity and possibility that the patient may be unlawfully obtaining prescription drugs illegally.
Due to the severity of the issue, Oklahoma’s state house and senate are constantly looking for ways to curb the prescription drug problems in the state. Because of this, a number of legislation is presented and passed every year, and this will likely continue until the crisis is more manageable. Some other laws that have been passed recently to combat the prescription drug epidemic include:
- House Bill 2931 - creates electronic prescribing for all schedules of drugs
- Senate Bill 1367 - creates a good samaritan law and can provide immunity to individuals who alert first responders to medical crises related to controlled substances
- House Bill 2796 - Starting on January 2019, every manufacturer and distributor will be required to register data on a quarterly basis to the Oklahoma State Bureau of Narcotics and Dangerous Drugs Control
- House Bill 2798 - Created the Opioid Overdose Fatality Review Board which will coordinate state and local efforts to address, research, and collect data on overdose deaths
What Else is Being Done
Besides laws, Oklahoma is taking other measures to ensure that the opioid epidemic is addressed.
For instance, in November the city of Oklahoma City filed a lawsuit against pharmaceutical manufacturers, distributors, and several doctors for their contributions to the opioid crisis. The defendants in the case are answerable to Oklahoma residents and taxpayers. The lawsuit says that the opioid companies downplayed the risk associated with opioids and overstated the benefits.
“The opioid epidemic is ravaging communities across the United States, but particularly in Oklahoma, as a result of corporate greed,” the lawsuit says
This is not the first time this has happened, in fact, it has been a continual occurrence over the past few years.
There are also a number of organizations in Oklahoma that have come forward to attack the drug problem in the state head on. One example of this is Drug Free Oklahoma. According to its website, Drug Free Oklahoma was established “in the hopes of bringing awareness to prescription drug abuse as well as help local Oklahomans find help with substance abuse.”
In October, the Department of Justice announced that they were awarding about $6 million to Oklahoma groups to help combat the opioid crisis. The money will be split up between multiple state agencies, but the Department of Mental Health and Substance Abuse is getting the largest amount at about $3 million. Other entities that will be receiving funds include the Oklahoma Bureau of Narcotics, the Muskogee Creek Nation and programs that work with children affected by opioid addiction.
As mentioned before, these steps paired with the laws that Oklahoma has passed provide a good starting point for combatting this prescription drug issue that the state has faced since the late-2000s and 2010s.
As you can see, there are a number of ways that Oklahoma is addressing the problems of prescription drug misuse and abuse in the state. While there is still more work to be done, the measures that have been taken may have contributed to the reduction of prescription rates and deaths over the past couple of years. Landmark Recovery is dedicated to providing patients with the care necessary to overcome the struggles of addiction. Landmark opened a new state-of-the-art drug and alcohol recovery facility in Oklahoma City in October. If you believe you are a loved one is suffering from substance abuse please feel free to reach out to our admissions staff to learn more about our drug and alcohol rehab facilities.