It's ok a doctor prescribed it!

Al Jazeera ^ | May 7th 2011 | John Terrett

[Cardhu]

In the United States the number of people hospitalised for prescription drug abuse has increased four hundred percent in the past ten years.

The small town of Portsmouth, Ohio is the epicentre of the problem.

Over thirty people - many in their early twenties - have died from prescription drug abuse.

One in ten babies born in Scioto County (Sy-oh-toe) last year tested positive for drugs.

Fatal overdoses have surpassed car crashes as the leading cause of accidental death in Ohio.

I met Andrea Queen, a reformed abuser at her new place of work in Portsmouth a clinic helping today's abusers.

A friend told Andrea to take a prescription pill one evening - "just to get the party going," he said. It led to a habit that nearly killed her. She told me:

"This growing sense of paranoia helped convince me that I needed to take myself out of this world that killing myself would be the one way out."

Ed Hughes is the Executive Director of The Counseling Center Inc and has been charting the rise of prescription drug abuse in Ohio. He shows me a series of maps showing the counties in the State ... each one he hands me gets progressively redder in colour.

"We had high admissions for opiate addictions in 2001 and then when we look eight years later in 2009."

Street clinics known as Pill Mills dole out the highly addictive opiate Oxycotton (OxyContin is the official name) to anyone with the money to pay for it some doctors in the area are cashing in on this big business. Ed told me:Scioto County is an area once known for steel and shoe making but which now has one of the highest rates of prescription drug abuse in the state of Ohio...and the country

."Most of the time they're doctors that have become marginalised in their profession they're, you know, they've had problems with their practice or problems with their hospitals ...more than one of the Pill Mills here in our community are owned and operated by people who have had past felony drug offences."

Andrea's recovering from the prescription drug hell that almost ended her life and now counsels others .. with a warning: "Don't do it doesn't get the party going it gets the addiction going."

Not everybody recovers from prescription drug abuse and a wall in the display window of an empty department store in Portsmouth is testimony to that.

It contains the names of thirty six people who have died in this area as a result of abusing prescription drugs.

Joanna Krohns knows this all too well. She lost her son Wes when he accidentally shot himself while high on painkillers. She's now started a group called Solace to help other grieving parents.

"When you lose a child it's such a devastating thing I didn't really know where to turn, who to turn talk to and I thought if I can just reach out to other parents give them somebody to talk to give them hope so that's kind of what I did."

The wall in downtown Portsmouth containing so many young faces - the majority were around the age of twenty two - is heartbreaking to look at.

Easy access to painkillers right across America means many more are likely to lose their lives too.

[headstamp 2]

The new opiate abuse. $30 to $50 bucks a pill around here for Oxy.

Guy in our town went away for 2+ years selling to an undercover for about a year.

[buccaneer81]

Portsmouth truly is a cesspool.

[NWFLConservative]

Another issue I deal with every day is wrong prescription for the situation. Depending on the situation, when we get a sample into my lab for culture, we may or may run a "susceptibility test". This is a test where we plate the sample onto an agar plate and then place up to 10 different disks saturated with different antibiotics. If the bacteria is resistant to that particular antibiotic, it will grow right up to the disk. If it is susceptible, you will get a ring of no growth called the zone of inhibition. The bigger the zone in mm, the more susceptible the bug is to it. We have charts we used to determine if it is sufficiently susceptible based on the size of the zone of inhibition. Normally the physician has to request a "C&S" (culture and senstivity) or we only do the culture part.

I wish I had a dollar for every time we get a STAT order for a susceptibility test from an doctor because his patient is not resolving or getting worse on the antibiotic he prescribed. Often this is a result of what is known as "empiric therapy" (trial and error) which is fancy med-speak for winging it . Granted if a patient presents to the ER with a very high fever and other signs of a bad infection, you may not have the 24 hours to wait for a susceptibility study, but still, giving a very sick patient a drug that is about as effective as giving them a shot of orange juice is not effective either.  Don't get me wrong, I have a tremendous amount of respect for physicians, especially Emergency Medicine physicians, but in our line of work, we view most things with very reasoned skepticism.

[TheOldLady]

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[Cardhu]

City Overview

“As of 2010, Portsmouth’s population is 19,847 people. Since 2000, it has had a population growth of -5.08 percent.

The median home cost in Portsmouth is $52,070. Home appreciation the last year has been -14.62 percent.

Compared to the rest of the country, Portsmouth’s cost of living is 24.30% Lower than the U.S. average.

Portsmouth public schools spend $4,904 per student. The average school expenditure in the U.S. is $5,678. There are about 18.2 students per teacher in Portsmouth.

The unemployment rate in Portsmouth is 12.40 percent(U.S. avg. is 10.20%). Recent job growth is Negative. Portsmouth jobs have Decreased by 3.25 percent.”

I just checked the status of Ohio - seems that it is part of the rust belt with super high unemployment.

[OldBullrider]

Drug abuse is drug abuse, no matter if it is prescription or illegal drugs.

[Cardhu]

Apart from misdiagnosed drugs there is the profit motive in unnecessary procedures.

Here is part of a letter to the Times in February 2011

Letter
The Price of Colonoscopy Published: February 22, 2011

To the Editor:

“States Aim Ax at Health Cost of Retirement” (front page, Feb. 14) describes steps taken by cities and states to control employee health care costs. One city, Wauwatosa, Wis., requires its employees to undergo “colonoscopy at age 50, to help forestall cancer and potentially high treatment costs,” you report.

Colon cancer screening with colonoscopy — viewing the entire colon — has almost completely replaced more limited sigmoidoscopy, which costs as little as one-tenth as much. Yet studies have repeatedly failed to show that colonoscopy reduces the risk of death from colon cancer more effectively than sigmoidoscopy.

Indeed, two national multidisciplinary task forces state that sigmoidoscopy is just as effective. Nonetheless, the American College of Gastroenterology recommends colonoscopy over sigmoidoscopy, and national health care legislation mandates that new coverage include screening colonoscopy.

Read more at:
http://www.nytimes.com/2011/02/23/opinion/l23colon.html

[buccaneer81]

Columbus and south of it were never part of the Rust Belt. Southern Ohio is agriculture and an Appalachian way of life. Portsmouth is an extension of Kentucky and West Virginia, without the charm.

[Vaduz]

Indeed it’s strange what the young and dumb call cool so their peers will except them,a weak lot indeed.I have no pity for anyone who goes out on the O.D. route.

[Cardhu]

Thanks for the correction - but what caused the loss of population and very high unemployment situation for a rural agricultural area.

[USNBandit]

Many of these people also suffer from a medical system there isn't the continuity of care required to walk the fine line between managing pain and becoming addicted.

I was lucky that the one time I needed pain meds for a prolonged period I was under the care of a doctor with a relatively small number of patients.

[NWFLConservative]

Part of the susceptibility testing is also finding the most cost effective drug for the job. Drugs for a particular bug are listed as A, B and C drugs. A drugs are the default. They have the highest efficacy for the buck. The only time you would go to the B class is the patient is allergic to it or the A drug just does not seem to be working. We never report B drugs on the MB report unless we are informed that a patient has an alergy to the A drug.

[NWFLConservative]

An even more cost effective screening method is a test where the patient swallows a small camera shaped like a large capsule. It takes pictures from the stomach, through the pyloris, jejunum and small and large intestines. It is excreted in the stool and returned to the gastroenterologist, where the images are downloaded computer and reviewed. I don't remember how frequently it shot photos but I do remember looking over at least a hundred, if not more images, with my wife and the gastroenterologist.

My wife was suspected of having polyps and this is what the did with her. Nothing of any consequence was found with the pill, so there was no need for a colonoscopy.

[buccaneer81]

Family farming is a dying enterprise in this country; Southern Ohio is a microcosm of that. A great many of the locals used to work in Columbus or Cincinnati, but the recession put them out of work, and the relatively few higher wage earners (for Southern Ohio, $50,000 is huge money) can’t support the small retail and service sector in the local area.
The number one cash crop is marijuana and federal and state social welfare programs provide most of the cash flow to the locals.

[Cardhu]

That is very interesting I have never heard of that procedure. My daughter is a nurse and hospital administrator in Saudi Arabia I will have to ask her about it.

[a fool in paradise]

[HiTech RedNeck]

Al-Jazeera?

Is this why the Slammies call America the Great Satan?

[Cardhu]

Your excellent summary of the conditions in Southern Ohio explains why the young folk and others are turning to drugs. No work and welfare programs tend to depress ones outlook on life.

I lived for a short time in Lincoln, Nebraska and Kansas about 20 years ago. It was my first encounter with fly over country after living in NY and PA. I was really impressed with both places.

I found that generally the people there were much more sophisticated than those back East. In Nebraska it seemed that all the children played golf. and in Overland Park south of Kansas City they had hundreds of restaurants that that were packed seven days a week. Not at all what one would think of back east.

I remember driving into Kansas City, Missouri in winter and coming over the hill looking down on the University area, which was entirely built in Spanish style, every building was outlined in small colored lights - it was absolutely amazing. I wish I had take a photograph of it but in those days we did not carry digital cameras around with us.

[buccaneer81]

Flyover country truly is America. The coasts are infested with the descendent dregs of early-mid 20th century European socialists/communists who polluted our society first through unions, then through local governments until gaining enough clout to destroy academia.