Prescription drug abuse is a huge problem on the Olympic Peninsula. Unfortunately, Clallam County has been at or near the top of Washington State counties in per capita unintentional opiate overdoses or deaths over the past 10 years. Almost all of these tragic mishaps involve illegally procured opiates in the form of heroin or pills.
I think a good way to approach the problem is to look at it in terms of supply and demand. Supply is primarily a regulatory and law enforcement issue. That’s the issue that the Olympic Peninsula Narcotics Enforcement Team (OPNET), under sponsorship of the Sheriff’s Office, Port Angeles Police Department, and the Washington State Patrol, targets as it works to find and arrest drug dealers. OPNET does not actively seek out or arrest illegal drug users — only drug dealers, and large-scale dealers at that.
County law enforcement agencies — county, cities, and tribal — have worked together to stem the illegal sales and distribution of prescription opiates through rigorous enforcement of drug trafficking laws and offering safe disposal for all unwanted prescription medications. Drop-off points — at the Clallam County Sheriff’s Office, Jim’s Pharmacy, Port Angeles Police Department, Sequim Police Department, and Forks Police Department — have taken thousands of pounds of unwanted prescription drugs, including opiates, and safely disposed of them.
The demand side of the drug problem is by far the more difficult and complex. Without demand — people wanting to use opiate drugs for non-medical purposes — there would be no drug problem. But I also do not see how arresting illegal drug user to protect them from themselves accomplishes anything other than racking up huge financial costs and social disruption.
Inappropriate and illegal use of opiates is, in my opinion, a public health and cultural problem that we can’t arrest our way out of. Why do so many of our youth want to use opiates on a regular basis? Why can’t our educational system and culture do a better job in discouraging “recreational” opiate use? Additionally, a major challenge of fighting prescription abuse is making sure people with real pain can access the medicines they need while preventing others from using them illegally.
Fortunately, there are new technologies to address the demand side challenge, reducing the risk of misuse and allowing physicians more certainty that when they prescribe pain medication it won’t be abused.
These technologies, called abuse-deterrent formulations (ADF), make it difficult to crush pain medications so they can be abused (i.e. smoked or nasally ingested). There is no single strategy and each is a little different. This helps ensure that even if abusers can find a way around one medication’s strategy, they can’t find a way around them all.
This is a great step forward in improving access to care while reducing the threat of abuse. State and private insurers should ensure these technologies are available; making sure insurance coverage is an option.
Insurance companies’ lists of preferred drugs should provide coverage for at least one abuse-deterrent product, so if a provider suspects someone could be at risk for misusing prescribed pain medication, they have another option. Legislation to do just that was introduced in the Senate this year, but it did not pass. I encourage the Legislature to seriously consider this issue in the next legislative session.
By ensuring parity coverage for ADF opioids, we'll have fewer people in our communities with access to medications that can be abused.
I fully support the use of ADF technologies for opiate pain medication.
Addressing prescription drug abuse means addressing both supply and demand and doing that in a way that doesn’t make it more difficult for those with legitimate pain to access medicines.
While there is more to be done here in Clallam County, we are taking the lead on fighting the supply. There is no one magic solution, however, and all of our efforts in combination, focusing on supply and demand, are part of addressing this problem.
