Long Beach Could Look to Curb Opioid Prescriptions Through “Detailing Campaign”

Over 60,000 people in the United States died last year as a result of drug overdoses with heroin, prescription opioids and synthetic versions of the drugs accounting for nearly 80 percent of those deaths. Accidental death by drug overdose has become the leading cause of premature death in the country.

While certain parts of the country—the Midwest and Appalachia—have been decimated by this epidemic states like California have also seen upticks in opioid-related hospital admissions and deaths.

During next Tuesday’s Long Beach City Council meeting Third District Councilwoman Suzie Price will introduce an item aimed at curbing the amount of opioids physicians prescribe through a process known as an “opioid detailing campaign” which could involve the city’s health department consulting with healthcare professionals and urging lower doses of opioid painkillers and eliminating the practice altogether for certain conditions.

First District Councilwoman Lena Gonzalez and Sixth District Councilman Dee Andrews are co-sponsoring the item that’s calling for a feasibility report on carrying out such a campaign in the city.

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Known as “judicious opioid prescribing”, one of the first of these campaigns was conducted in Staten Island, New York in 2013 where public health workers advocated for changes in the ways these drugs were prescribed. Recommendations made during the study period were for physicians to limit painkiller supplies to three days, avoid prescribing opioid painkillers for chronic non-cancer pain and to avoid high-dose prescriptions.

The program resulted in prescribing rates and high-dose prescriptions dropping in Staten Island. Similar positive impacts through campaigns in Utah and rural North Carolina have also been witnessed.

Price thinks that the same tactics can be used to help reduce the impact of the opioid epidemic in Long Beach.

“To the extent that we can lessen those drugs on the market and the black market I think it will result in a societal benefit,” Price said. “A lot of these drugs are not obtained by the end-user through prescription, but someone is obtaining a prescription for way more than they need and maybe doing so on a regular basis and selling the drug and that’s where we see a lot of addiction start.”

She said that the issue here in Long Beach is as bad, if not worse, than the situation in Orange County where she serves as a deputy district attorney. However, she said that the situation in Orange County seems to be more with prescription medication whereas Long Beach has tended to have more of an issue with heroin.

The two have become inextricably linked as the opioid epidemic has exploded in this country with a growing number of people starting out with a reliance on prescription pain medications like Oxycodone, Vicodin and Percocet and then being forced to switch to cheaper alternatives like heroin to feed their habit.

Oxycontin can cost upward of $60-$100 per pill on the streets while multiple doses of heroin can cost half as much.

While Long Beach Health and Human Services does not track opioid overdoses in the city, the County of Los Angeles does. Since 2010 the number of opioid-related hospital visits, admittance and deaths in Long Beach has remained relatively static but has outpaced that of the rest of the county.

During those years the city has seen at least 10 opioid deaths each year with a high of 19 deaths being recorded in 2013. The number of hospital visits due to opioid-related issues has averaged about 100 per year.

In March, Director of the California Department of Public Health Karen L. Smith sent out a letter to physicians in the state reiterating the need to exercise caution in prescribing such drugs to patients. The letter included links to treatment centers and local and federal guidelines for prescribing opiates to patients in an effort to help reduce the nearly 2,000 opioid-related overdose deaths the state saw in 2015.

“We recognize providing safe and effective pain management can be challenging. We understand there are multiple complexities to be considered in pain management when treating patients with acute and chronic pain,” Smith wrote. “One of the most difficult situations for prescribers may be how to respond to patients with difficulty decreasing opioid intake or with other possible addiction symptoms. It is our hope that these resources can help you maintain your clinical relationship with your patients who are using opioid medications and improve their overall well-being.”

The board’s recommendations for those patients who should receive opioid prescriptions include those with cancer, suffering from acute pain or going through end-of-life procedures. It clearly outlines that for drug-seeking patients using emergency rooms as a means of acquiring prescription drugs that the dosage should remain low and the supply should last less than a week.

Price said that she understands that the item will not completely fix the problem but it’s a step in the right direction. She intends to bring forward a second opioid-based item to the council in the coming months in an attempt to see if it’s feasible for Long Beach Police Department officers to join the city’s fire department in carrying Narcan, an inhalant used by first responders to reverse opioid overdoses.

While Narcan is a reactive remedy to the opioid crisis, Tuesday’s item will attack from the other side in trying to reign in the practice of over prescribing pain medications that have fed the country’s growing addiction to opiates.

“They’ve [the pharmaceutical industry] marketed these opioids as regular pain management to deal with things like wisdom teeth being removed or routine kind of surgeries and that’s not the intent of these opioids,” Price said. “These opioids, like Oxycodone, are really designed to deal with the kind of pain that comes with terminal illness, life-ending type of pain. Pain that’s extremely unable to be dealt with by any kind of medication, kind of like a last resort type medication.”



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