An epidemic of opioid addiction prompted a vigorous discussion Saturday among local health leaders and U.S. Sen. Ron Wyden as they looked for answers in dealing with the national problem.
“Opioid abuse is hitting Oregon like a wrecking ball,” said Wyden, a Democrat.
The senator met with more than 20 healthcare leaders at the new La Clinica health care facility on Biddle Road in Medford.
“How is it happening that so many are getting addicted in the first place?” Wyden said. “Maybe we’ve made it too simple.”
Dr. Jim Shames, Jackson County medical director, said there are too many addictive pain-killer pills available in the community, and the dilemma for the health-care industry is how to turn off the spigot.
“The source of the pills comes from me and from everybody else who writes prescriptions,” Shames said.
Commonly prescribed opioids include hydrocodone and oxycodone that come in brand names such as Percocet, Vicodin and OxyContin. More powerful opioids include morphine and fentanyl.
Shames and other healthcare professionals told Wyden that doctors were criticized a decade ago for not prescribing enough pain killers. Now, the pendulum has swung and doctors are blamed for writing too many opioid prescriptions.
Dan Weiner, chief medical officer at Rogue Community Health in Medford, said some doctors are less willing to prescribe pain killers now because of the backlash against opioids.
“They’re afraid of sanctions,” he said.
When doctors attempt to wean people off pills such as oxycodone, patients sometimes turn to the street for their drugs. Some attempt to buy pills in the black market, but they soon find that heroin is the cheapest alternative.
Patients also attempt to obtain the medications through so-called “doctor shopping” or by going to emergency rooms. In some cases, California residents head north to Oregon to get pills at an emergency room because they cannot be checked in the state's system.
Rita Sullivan, executive director of OnTrack, said she is seeing increases every month of people addicted to pain killers.
At the same time, the spike in intravenous drug use by those on heroin has caused a hepatitis C epidemic.
Wyden said, “We could blow our entire Medicaid budget for drugs on hepatitis C drugs.”
Josh Balloch, vice president of government affairs and health policy for Allcare Health in Grants Pass, said his organization could spend 30 percent of its budget on treating hepatitis C patients because of the high cost of the medications.
Health care professionals told Wyden that opioid prescriptions are an effective treatment program in many circumstances, though some suggested that many doctors need to receive better training before they prescribing these pills.
Wyden said he would push for an investigation into pharmaceutical companies to determine if their marketing efforts have had a hand in promoting excessive opioid prescriptions.
Wyden also said he was interested in a proposal by U.S. Sen. Elizabeth Warren, D-Mass., to increase the use of medical marijuana as an alternative to opioid prescriptions.
Warren sent a letter to Centers for Disease Control chief Tom Friedan asking the agency to look into whether federal legalization of medical and recreational marijuana could have an impact on opioid overdose deaths.
Wyden said Oregon and other states have led the nation in decriminalizing marijuana, but noted the federal government continues to list it as a Schedule 1 drug in the same category as heroin.
"The federal scheduling of marijuana has flunked the test of keeping up with the times,” he said.
Reach reporter Damian Mann at 541-776-4476 or firstname.lastname@example.org. Follow him on Twitter @reporterdm.