Op-Ed: Kent County Tops State in Oxycodone, Hydrocodone Prescriptions by Dan Watson

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Having gone to court to win access to the information, The Washington Post and a small West Virginia paper, the Charleston Gazette-Mail, have pried loose evidence that 76 billion oxycodone and hydrocodone tablets were distributed in the US over a seven-year period 2006-2012. Seventy-six BILLION. Any wonder we’ve suffered a nationwide opioid epidemic?

And this data covers only those two pills; it does not include Oxycontin, Percocet, Valium, and so forth—all of which are dangerous and part of the problem.  Access to the Drug Enforcement Agency (“DEA”) database obtained by the Post enables any reader to drill down to annual data on a County basis, Visit here.

I write from the Talbot County perspective.  Kent County leads Maryland in the legal distribution of the opioids studied dispensing 170 percent of the state average per person.  Three of the top five counties are on the Eastern Shore, including Cecil and Worcester. Talbot County led Baltimore City and Baltimore County, but both were in the bottom half of the list and both below the state average.

As I scanned the Post’s stunning articles with their dynamic maps and graphics, I thought of the Shore-wide “Go Purple” campaign that certainly raised public consciousness of the opioid crisis in our region. 

Pharmacies in Talbot County dispensed 33 oxycodone and hydrocodone pills for every man, woman and child in Talbot County, on average, over those seven years. That sure looked like a lot to me. I was inclined to chalk it up to our older population (median 49.7 years, 12 years older than state average!). We must have the highest number of joint replacements per capita of any County in Maryland if my circle of friends is any indicator.

By contrast, pharmacies in Kent County dispensed 59 oxycodone and hydrocodone pills per person, on average, over those seven years.  The obvious question to my friends in Kent County is, Why was your rate of distribution of these dangerous drugs almost twice Talbot’s, and four times that of Montgomery and PG?  I for one am a loss for a reasonable hypothesis, although I don’t know your County as well as I should.

If there is good news, it is that the DEA data reveals that Maryland was spared complete devastation compared to other areas of the Country, particularly Appalachia where in Mingo County WV the average was 203 pills per person over seven years!

Having identified Kent as a high use county, it would seem the medical community must take an aggressive role in monitoring patient use and potential misuse.  Heading off abuse of opioid prescriptions continues to be unified effort led by local law enforcement in every county. Eastern Shore counties will start ramping up for “Goes Purple” campaign soon.  

I wanted to learn more about the law enforcement perspective on this report so I sat down with Talbot County Sheriff Joe Gamble who was happy to spend an hour to drill down into its meaning locally. His main points were these:

Importance: The national data and patterns are obviously jaw dropping. At the State and County levels it could also be very useful to uncover outliers. The data shows individual pharmacy and physician fulfillments (though not individual prescriptions). 

Timeliness: The publicly released data set is seven years old. It would have been more helpful before the horse was out of the barn. Since 2012 the drug scene has morphed somewhat.

Pills In Context: Prior to about 2012 pills of all sorts—especially oxycodone and hydrocodone—were a dominant problem because they were cheap and available. Since then, for many reasons, pills have become less available and—in relation to heroine especially—more expensive. Consequently, pills are today dangerous mostly as a “step on the ladder” (Sheriff Gamble’s phrase): a kid who may have toyed with alcohol or marijuana gets his (or her) hands on a pill or two, and experiences that first opioid high. It may be a brief plateau, but once addiction takes hold, the much cheaper and available heroine becomes the main drug of choice.

Two Things People Need To Do: First, sort through your meds for any drugs you do not really need at present….not just expired drugs, but those “left over.” Don’t save them for a rainy day. Deposit them directly into the (free and anonymous) dropbox situated right in front of the Sheriff’s Office on Vickers Drive off of Flatland Road. Second, as to any drugs you need to keep on hand, do not let them simply sit in your medicine cabinet. Lock them up somewhere. We all think of the risk of teenagers or kids getting hold of them, but really anyone with incidental access (cleaners, repairmen) can lift a few little pills (worth $30 or $40 each), and if the whole bottle doesn’t disappear, who’s to notice?

The flood of opioids is a historic, world-class scandal. How many Americans—including some in Kent and Talbot County– have died unnecessarily? How many equivalent World Trade Towers went down, and nary a terrorist to be seen?

Many want to crucify the profit driven players in the opioid trade itself—the manufacturers, the wholesale distributers, and unscrupulous or careless pharmacists and prescribers. But blame is shared by those responsible for regulating this dangerous business, whose indifference and ineptitude–and probably worse–denied Americans the protections that should have applied. Responsibility rests ultimately on the lawmakers on both sides of the aisle who failed us over many years.  And of course patients need to be wary of using opioids to solve long-term pain issues.  

Meanwhile, do your part today. Check that medicine cabinet, find those unused dangerous meds, and discard properly (NOT down the toilet).  Any questions, call your local sheriff’s department.  

Dan Watson is the former chair of Bipartisan Coalition For New Council Leadership and has lived in Talbot County for the last twenty-five years. 

 

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