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    Painkiller Prescriptions Vary Widely Among States

    Death toll can be reduced with better oversight, agency says, citing success in Florida


    The declines in Florida deaths linked to specific prescription painkillers -- oxycodone, methadone, and hydrocodone -- paralleled declines in prescribing rates for those drugs, the researchers said.

    Florida officials took action after drug overdose deaths surged 61 percent between 2003 and 2009, the CDC reported.

    The prescription drug epidemic in Florida became so rampant that other states were drawn into the drama, said Dr. M. Fahad Khan, assistant professor in the Department of Anesthesiology at NYU Langone Medical Center in New York City.

    "Practicing pain medicine all the way up here in New York did not mean you were immune to the problems going on in Florida, as many of our patients here in the state often had their opioid prescriptions started for them by doctors in the Sunshine State," Khan said. "As a pain medicine specialist, your ears automatically perked up when you saw the patient's state of residence listed as Florida on your clinic intake form."

    The Florida state Legislature in 2010 implemented laws that strengthened regulation of pain clinics, which had been a major source of questionable narcotic drug prescriptions, the CDC said. The clinics had to register with the state, and were prohibited from dispensing narcotic painkillers from their offices.

    Law enforcement followed up with a series of high-profile raids across the state.

    All drug overdose deaths in Florida -- including prescription and illicit drugs -- decreased 18 percent from 2010 to 2012. And that dramatic decline occurred even though the death rate from heroin overdoses more than doubled in the same time period.

    The CDC said states that want to get serious about tackling prescription drug abuse can:

    • Improve use of prescription drug monitoring programs, which can identify doctors and pharmacies that appear to be overprescribing narcotic painkillers.
    • Tighten regulation of pain clinics.
    • Increase people's access to substance abuse treatment.

    But even more effective would be a nationwide prescription monitoring database that crosses state lines, Khan said. He has access to New York's prescription monitoring database, but finds it of limited use in checking his patients' medication use.

    "As a large portion of my patients reside in New Jersey or Connecticut, and therefore have their prescriptions filled there as well, these patients do not show up in the database at this time," Khan said.

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