CDC, Drug Czar Both Focusing On  Prescriptions  In Overdose Deaths

Two leading federal authorities on illegal and prescription drugs may initially appear at odds over the incidents of use versus overdose deaths in the United States. But both organizations recognize a growing trend in prescription abuse, which is ratcheting up overdose statistics at an alarming rate.

Illegal drug use in the United States has dropped sharply since 2001, but abuse of prescription drugs remains a problem, according to the director of the White House Office of National Drug Control Policy announced last week.

John Walters said that President Bush’s antidrug plan for 2007-08 is to reduce prescription drug abuse by 15 percent over three years. The administration ranks the problem second only to marijuana.

Another agency has found that unintentional fatal drug overdoses in the United States nearly doubled from 1999 to 2004, overtaking falls to become the nation’s second-leading cause of accidental death, behind automobile crashes.

The number of accidental drug overdose deaths rose from 11,155 in 1999 to 19,838 in 2004, according to the Centers for Disease Control and Prevention. That report was based on death certificates, which do not clearly detail which drugs played the greatest role.

But CDC researchers said they believe sedatives and prescription painkillers such as Vicodin and OxyContin were the chief cause of the increase. OxyContin has been blamed for hundreds of deaths across the country in recent years, becoming such a scourge in Appalachia that it is known as “hillbilly heroin.”

Mr Walters’ report also singled out OxyContin as one of the prescription drugs most abused. The report calls for more states to adopt prescription drug monitoring programs to prevent “doctor-shopping” to get prescriptions for more drugs.

Mr Walters said overall use of illegal drugs among young people is down 23 percent from 2001, with 840,000 fewer teenagers using drugs now. He credited drug testing for much of the decline and urged its expansion in schools.

He also said abuse among older people declined.

About 1,000 school districts carry out drug tests, which can trigger an intervention that keeps a young drug abuser from carrying the habit into adulthood, Mr Walters said. Despite some concerns for invasion of privacy, he said, the United States will “look stupid in five or ten years if we don’t do this.”

Mr Walters said the data came from a survey done at the University of Michigan for the National Institute For Substance Abuse. The report says about 19.7 million Americans reported using at least one illegal substance in the previous month.

In Washington, D.C., Bill Piper, director of affairs for the Drug Policy Alliance, called the strategy a “spin on the failure of the war on drugs.” He said in a statement that despite incarcerating millions of Americans, drugs are as available as ever and the related harms of addiction, overdose, and the spread of disease continue to mount.

Mr Piper said drug use rates are less important than whether the death, disease, crime, and other suffering associated with abuse go up or down.

Looking at regional statistics, a previous CDC report indicated the South had one of the lowest fatal drug overdose rates in the nation in 1999, but it doubled by 2004. The South now ties the West for having the highest rate — about eight per 100,000 population.

“This is the first study really to describe the large relative increases in poisoning mortality rates in rural states. Historically, the drug issue has been seen as an urban problem,” said Dr Len Paulozzi, a CDC epidemiologist.

The federal report, issued this week, noted that accidental drug overdoses remain most common in men and in people 35 to 54. But the most dramatic increases in death rates were for white females, young adults, and Southerners.

Other findings include:

*The death rates for men remained roughly twice the rate for women, but the female rate doubled from 1999 to 2004 while the male rate increased by 47 percent.

*The rate for white women rose more dramatically than for any other gender group, to five deaths per 100,000 population.

*The rate of overdose deaths among teens and young adults, ages 15 to 24, is less than half that of the 35-to-54 group. But it rose much more dramatically, climbing 113 percent in the study years, to 5.3 deaths per 100,000 population.

About 50 percent of the deaths in 2004 were attributed to narcotics and hallucinogens, a category that includes heroin, cocaine, and prescription painkillers like Vicodin and OxyContin.

Earlier research suggests that deaths from illegal drugs appear to be holding steady.

“There is a misperception that because a drug is a prescription medicine, it’s safe to use for nonmedical reasons. And clearly that is not true,” said Dr Anne Marie McKenzie-Brown, a pain medicine expert at Atlanta’s Emory Crawford Long Hospital.

This report consists of two combined Associated Press reports.