Last year’s PMP prescriptions were written by 12,096 doctors, osteopaths, dentists, physician assistants, nurse practitioners and other medical professionals. Of those, 3,529 registered prescribers ran PMP checks during the year.
Some of the prescribers were located out of state and can’t access Oklahoma’s PMP system before writing prescriptions, bureau officials said. Some were Oklahoma practitioners who write only a handful of controlled substance prescriptions per year and aren’t necessarily expected to check the PMP regularly.
Officials say the usage statistics understate prescriber participation in the PMP system, which is designed to deter “doctor shopping” by allowing doctors to see every narcotic prescription filled by a patient during the previous 12 months.
In some clinics, for example, one staff person might be running PMP checks for several doctors but entering only one registration number for each check. Also, one PMP check might apply to several prescriptions being written at the same time by a single doctor.
Bureau officials said about 74 percent of Oklahoma prescribers who wrote more than 10 controlled substance prescriptions logged into the PMP system at some point last year.
Fallin’s office is working with lawmakers, law enforcement authorities, health officials and medical practitioners to devise a collaborative strategy acceptable to all sides. It is likely to include new restrictions on prescribing practices, tougher penalties for offenders and more public and professional outreach campaigns.
“We’re all in this together,” Weaver said. “We’re not going to arrest our way out of this problem. We’ve got to have our physicians involved. They’ve got to police themselves.”
Fatality count climbs
The latest overdose data show Oklahomans are being killed by prescription drugs at a rate of nearly two people per day.
The drug overdose fatality count climbed 80 percent over the past decade. Deaths caused by hydrocodone and oxycodone more than quadrupled over the 10-year period.
Weaver said he’s perplexed the toll has continued to rise despite concerted efforts to call more attention to the problem, which claimed the life of University of Oklahoma linebacker Austin Box and sidelined the career of Oklahoma State University basketball coach Sean Sutton.
“This is something that’s affecting normal Oklahomans,” Weaver said. “School teachers. Police officers. People who are out there functioning in their day-to-day business.”
At least Oklahoma no longer ranks No. 1 in prescription painkiller abuse, as it did several years ago. The latest survey by the federal Substance Abuse and Mental Health Services Administration shows the Sooner State has fallen to No. 8 on the prescription drug-abuse list.
According to the 2012 survey, 5.2 percent of Oklahomans above the age of 11 took prescription pain medicines for nonmedical reasons during the previous 12 months. The biggest pill poppers were 18- to-25 year-olds, who had an abuse rate of 10.9 percent.
State officials and addiction specialists say they have been particularly alarmed by recent data suggesting some people who become addicted to prescription painkillers eventually switch to street heroin.
“We’re learning that it’s become a gateway drug to heroin,” said Mullins, the governor’s attorney.
The danger of rising heroin use made headlines recently when actor Philip Seymour Hoffman died of an apparent overdose. Authorities said they found heroin and prescription drugs at his residence. Hoffman told an interviewer he had resumed a history of drug abuse last year by taking prescription painkillers, then progressing to heroin.
Hal Vorse, a physician who treats habitual drug users and teaches new doctors about addiction at the University of Oklahoma Health Sciences Center, said he’s seen the phenomenon in his own practice.
“We’re seeing a big surge in heroin, and 85 percent of those people started on prescription opiates,” said Vorse. “The cost of their addiction got so high that they switched to heroin because it’s cheaper.”
Vorse said the price on the street for OxyContin has risen to $1 to $1.50 per milligram. Addicts typically use 200 to 300 milligrams per day, he said.
“They find out they can get an equivalent dose of heroin for a third of what it costs for Oxys,” Vorse said.
“It’s just like Prohibition in the ’20s. People who couldn’t get good whiskey bought moonshine. The problem with heroin is there’s no quality control. You don’t know what you’re getting.”