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Butler County overdose epidemic traced to 1990s medical practices

The opioid epidemic has been called the worst public health crisis in American history. People talk about the crisis as if it’s a new phenomenon, but officials say it’s the culmination of a decades-term problem stemming from prescription opioids.

“The reason we’re number one in the nation for overdose deaths is because we have a pain killer problem,” said State Rep. Robert Sprague, R-Findlay. “We prescribe and have prescribed in the state of Ohio a progressively higher number of prescription pain killers that have come through our medical system.” 

The opioid crisis skyrocketed about a decade ago in southwest Ohio when so-called pill mills had people lined up to get narcotic prescriptions.

Ohio doctors prescribed nearly 800 million doses of painkiller narcotics in 2011, and by early 2016 were prescribing more medicine than in any other state in the country, according to the Ohio Department of Health’s annual overdose report. 

“The people would come in and they would pay $250 to the doctor and the doctor would write them a script for 600 OxyContin, and that was the entire doctor’s office. They were pill mills,” Sprague said. “You would walk in, and there would be lines of people waiting to get these prescription narcotics and these doctors just wrote those prescriptions and filled basically their coffers with a bunch of cash.”

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With that came the state’s addiction to painkillers, he said.

“Then as their addiction deepens, they’ve got to have stronger product,” Sprague said, leading to more use of powerful illegal opioids like heroin.

The Centers for Disease Control and Prevention also outlines the current epidemic in a similar way:

  • The first wave began with increased prescribing of opioids in the 1990s, with overdose deaths involving prescription opioids increasing since at least 1999.
  • The second wave began in 2010, with rapid increases in overdose deaths involving heroin.
  • The third wave began in 2013, with significant increases in overdose deaths involving synthetic opioids — particularly those involving fentanyl 

“As the illicit use of heroin and prescription opioid medications has increased, so has the rate of overdose death,” said Phillip Walls, a spokesman for the Substance Abuse and Mental Health Services Administration. “Other factors, such as the use of more powerful opioids and using opioids along with benzodiazepines, have also contributed to the increase in overdose deaths.”

“Factors that contributed to this use include an increase in prescriptions and an increased supply of opioids through other means, such as obtaining them from someone who had a prescription or obtaining prescription opioids that have been diverted from the health care system,” he said.

Dr. Michael Lyons, an associate professor in the Department of Emergency Medicine at the University of Cincinnati College of Medicine, said there is still much debate about how to best prevent opioid addiction.

“We know that there was a direct parallel between a dramatic increase in opioid prescribing and the rise in opioid overdose deaths,” he said, adding that people who became addicted turned to heroin and other opioids easily available for less cost.

” What we do not know is how much of the opioid epidemic is a direct and specific result of therapeutic use, meaning patients taking opioids only as directed by their own physician who was acting in good faith to treat pain,” Lyons said.

Research has yet to identify the true risk of using opioids medically and how that risk varies by individual and circumstance, he said.

“The opioid epidemic should serve as an enduring lesson to the medical community about the importance of basing clinical practice on high-quality scientific evidence rather than messaging from industry and experts with conflicts of interest,” he said.

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