Hawaii, nation facing opioid epidemic
Stacy Lenze is on the front lines of the opioid addiction epidemic in Honolulu.
As a community health outreach worker, she’s heard frightening stories about people trying to help friends overdosing on narcotics like opioids by injecting them with everything from saltwater to milk.
Lenze is distributing life-saving medication and training people to administer shots of the drug naloxone, which can reverse the effects of heroin or opioid overdoses.
Drug overdose deaths in Hawaii increased by 83 percent from 2006 to 2014, a growth rate more than double the national average of 37 percent, according to the Centers for Disease Control. Prescription opioids and heroin account for the majority of drug deaths, the CDC said.
“There is a huge epidemic throughout the U.S., and Hawaii’s not immune,” said Dr. Tricia Wright of Honolulu who’s working with a nonprofit organization to distribute naloxone. “We’ve lost so many people from opioids.”
Hawaii’s isolation may contribute to its high overdose rate, because the quality of drugs brought onto the islands is inconsistent, Lenze said.
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“Somebody might use the same amount that they’ve always used, but it’s a different quality level,” she said.
A joint investigation by The Associated Press and the Center for Public Integrity found that drugmakers that produce opioid painkillers and allied advocacy groups spent more than $880 million on campaign contributions and lobbying over the past decade as they worked to influence state and federal policies. The groups have an array of political interests that include opioid advocacy, and their spending was eight times that of the gun lobby during the same period. By comparison, groups advocating for limits on opioid prescribing spent about $4 million.
The investigation comes as the number of overdose deaths from prescription painkillers has soared, claiming the lives of 165,000 people in the U.S. since 2000. Reporters analyzed campaign finance and lobbying data from 2006 through 2015, reviewed hundreds of documents and conducted more than 150 interviews. The AP and Center for Public Integrity found that drugmakers and allied groups employed an annual average of 1,350 lobbyists in state capitals around the country and contributed to a total of 7,100 candidates for state-level office.
The groups spent far less money in Hawaii than in other states. Contributions to Hawaii candidates from companies that manufacture opioids amounted to less than $40,000 from 2009 to 2014, about 1 percent of the campaign spending that poured into California.
Hawaii lawmakers passed a bill this year that in most cases prevents health care providers from prescribing more than a 30-day supply of opioids. The law, which went into effect July 1, also enables more health care providers to use a database that tracks painkiller prescriptions.
State Sen. Josh Green, an emergency room doctor, introduced several bills aimed at curtailing opioid abuse in recent years despite receiving campaign contributions from Pfizer, which manufactures opioids.
“I’m all in to curtail narcotic medication pills, and I am very aggressive irrespective of what the pharmaceutical industry wants,” he said.
Drug companies say they are committed to solving the problems linked to their painkillers. Purdue Pharma, one of the largest opioid producers by sales, said it does not oppose policies “that improve the way opioids are prescribed” even if they result in lower sales.
It took several years for Hawaii lawmakers to pass legislation to limit opioid prescriptions. In 2013, Green’s bill that would have prohibited health care providers in emergency rooms from prescribing long-acting opioids died. An effort in 2015 to limit the number of times doctors could prescribe opioids also failed.
During that time, several lawmakers who led committees on health and consumer protection were receiving campaign donations from Pfizer and Pharmaceutical Manufacturers of America, a drug trade group. The donations were small and they said Pfizer and the trade group weren’t lobbying against the proposals.
“They have never in my memory lobbied on any of the opioid legislation,” said Sen. Rosalyn Baker, chairwoman of the Commerce, Consumer Protection and Health Committee, who was among those receiving donations.
Pfizer spokeswoman Sharon Castillo said the company wasn’t involved with Hawaii’s proposed opioid legislation. Its legislative priorities in the state included working to increase vaccination rates, among other things, she said in an email.
The company has been educating prescribers on the appropriate use of pain medications, promoting access to opioids manufactured in a way that makes the pills harder to break down and abuse and supporting the use of prescription drug monitoring programs, she said.
A spokeswoman from Pharmaceutical Manufacturers of America said the company doesn’t comment on lobbying. But she emailed a statement saying the group is committed to working with policymakers and providers to combat opioid abuse through mandated education on appropriate prescribing, training and use of databases to prevent abuse, and clinical guidelines for prescribers.
Rep. Della Au Belatti, chairwoman of the House Health Committee and also a donation recipient, said she wasn’t lobbied by the pharmaceutical industry. She said Hawaii is behind states with more aggressive laws, such as those that limit opioid prescriptions to a seven-day supply, but she and others are pushing to catch up.
For example, doctors in Hawaii are required to sign up for a database that tracks painkiller prescriptions, but they’re not required to enter information, an issue that could be addressed with future legislation, Green said.
He said he’s seen teenagers and others suffering from car accidents, head injuries and fatalities because of addictions to painkillers they should have never been taking.
“That’s heart-wrenching, because those are totally preventable tragedies,” Green said.
14 responses to “Hawaii, nation facing opioid epidemic”
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They should not be treating patients with legitimate pain from real conditions like criminals. Where is the compassion? This will increase suicide rates as more and more suffering patients can’t bear the pain. We treat our pets better. Yes there is abuse just like with alcohol and other drugs. But treating tutu like a criminal is not the way to go. Stop making laws that handcuff doctors .
Stop the problem before it starts.
Compassionate care begins with a proper diagnosis, then an appropriate treatment. “quickie clinics” and uninformed health care providers inappropriately prescribe addictive painkillers, thereby creating the problem here and on the mainland. By the time you have to see a “pain specialist” the cat is already out of the bag.
There are safer options to ask your health care provider about: Acupuncture, Regenerative Medicine and Rehabilitation, Physical Therapy, or Osteopathic Manual Therapy are ways to resolve painful conditions before starting narcotics or addictive painkillers.
Best way to take care of Tutu is getting better care from the get-go.
Exactly.
Recent studies have shown that the opioid death rates have fallen between 16% and 33% in states that allow marijuana to be prescribed. Additionally, prescriptions for opioids have fallen in those states. That, of course, is why Big Pharma opposes medical marijuana.
Addiction in the Philippines have fallen more dramatically: We need Dutarte and his radical dope addicts elimination.
Very good news – increased opioid drug addiction deaths results in less non-productive people in Hawaii and the U.S. mainland.
It would be good , but unfortunately now they want to distribute free live saver kits against overdoses.
Homeless included? Since the use of pakalolo became legal in Hawaii did it have any correlation to the 83 percent rise in opioid addiction or meth use?
Perhaps the medical marijuana program will help to curtail the problem.
The approach we need requires us to correct our fundamental misunderstanding of the physiologic pain response. This is the root cause of the opioid crisis.
The current opioid epidemic is a direct result of the reckless over-prescribing of narcotic medications to artificially block pain.
The American Medical establishment let itself be mislead for a decade by propaganda from Purdue Pharma and other drug companies, ignoring ample clinical and historical information about the adverse public health impacts of these drugs.
In the short term, blocking pain is cheap and appears effective and compassionate. Unfortubately, this hampers the healing process and often results in more pain, suffering and disability over the long run, as well as addiction to these drugs. Few doctors, including “pain specialists”, really understand our precious physiologic pain response and how necessary it is for continuously keeping our tissues healthy.
Now we are stuck with another opioid epidemic with the constellation of devastating impacts, including progressive inflammation and joint damage, daily rollercoaster of sedation alternating with irritability and distress, severe constipation, disability, depression, financial distress, reliance on welfare benefits, family breakdown, criminal behavior, addicted infants, viral hepatitis and HIV from needle sharing and overdose deaths.
This public health disaster and a tragic reflection of the ignorance of those currently in change of our health care “industry”.
BTW, a similar dynamic of misinformed, profit-driven leadership is driving the Medical Marijuana community, with exaggeration of benefits, downplaying of risks, and ‘snake oil” promotion.
Undoubtedly, Cannabis could be much much safer than Opioid drugs for long term use, but there are still significant health risks. Cannabis can be part of the solution for the opioid epidemic, but the best approaches for pain caused by inflamed or damaged musculoskeletal tissue (the most common cause of pain) are gentle movement-based activities guided by an intact pain response.
If people are taking drugs that they shouldn’t be taking and dying as a result, why do the rest of us have to expend any effort or money to save them? This is a free country, the drug abusers know the consequences, so let them do kill themselves. The hospitals and ambulance services should not be treating drug abusers unless they can pay the cost.
If people want to help them, fine, it’s a free country. However, they need to use their own money and not get any taxpayer money.
What if they had no addiction problem, had a sore ankle, knee or back, were given opioids by doctors and nurses, and were told, “You need these. The risks are low. If you have genuine pain you won’t get addicted”?
This is what has happened. Hospitals have been pushing their use because the short-term pain relief and sedation keeps patients comfortable, allowing fewer nurses to care for more patients, saving money. This has been done by the medically false mandate that now “pain is the 5th vital sign”.
In the long run, of course, outcomes have worsened and medical costs have gone up as these patients’ tissue health deteriorated and the addiction-related problems emerged.
Just because some people are addicted to opioids and having problems does not mean everybody prescribed opioids is addicted, overdosing, and having problems. This becomes one of those “throw out the baby with the bathwater” situations. The media and anti-drug lobby will have opioids for all people. This would be a major mistake. Under this mind-set if one person has an adverse to a presribed drug, we should eliminate the drug for all people. In the end, all drugs would be prohibited for everybody and people would die all over the place.