Utah Sets New Standards for Painkiller Abuse—and Not in a Good Way

Approximately 62 percent of all Utah residents are of the Mormon (LDS) faith. As part of its strict code of personal conduct, the Church of Jesus Christ of Latter-day Saints prohibits members from using alcohol, tobacco, coffee, tea or illegal drugs. While the campaign to legalize marijuana is picking up steam across the country, in Utah access to even alcohol is still highly restricted, more than 80 years after the end of Prohibition.

But if Utah’s residents are behind the curve on illegal drug and alcohol use, they are leading the pack when it comes to prescription drug abuse. In 2004-2005, the U.S. Department of Health and Human Services released statistics that identified Utah as the nation’s biggest misuser of prescription medications. At that time, 6.5 percent of the state’s residents were identified as active prescription drug abusers, meaning they were taking pills without a doctor’s permission and without medical guidance or supervision.

Not much has changed in the decade since those figures came out. In a more recent survey, a shocking 97 percent of Utah residents admitted using prescription drugs obtained from friends and relatives, without a physician’s order, at some point in their lives. While the majority of these individuals were likely self-medicating in response to illness and not attempting to feed an existing dependency, this behavior shows a lack of knowledge if not downright naiveté about how dangerous it is to fool around with potent medications that can addict and kill.

Narcotic Painkillers Are Killing More Than Pain

Among all prescription drugs, none is more hazardous when used incorrectly than opioid painkillers, and it is this category of medication that has taken the heaviest toll in Utah. According to data recently released by the Utah Department of Health, the percentage of Utahns dying from prescription painkiller overdose rose by approximately 400 percent between 2000 and 2012. As hard as it is to believe, this actually represents an improvement over 2007, when annual death rates traceable to prescription opioid overdose were almost 40 percent higher than in 2012.

In raw numbers, 326 Utah citizens died in 2007 from toxic reactions to legal opioids, forcing the state’s government to acknowledge the scope of the problem and take action. Public funding for programs designed to counteract prescription drug abuse was expanded dramatically, and current efforts are concentrated under the umbrella of the state’s “Use Only as Directed” campaign.

These actions have had a positive impact. But public health officials have been disappointed by an uptick in prescription painkiller deaths since 2010, when fatality rates dropped to 11.9 per 100,000 adult Utah residents. By 2012, that number had risen to 12.7 per 100,000, apparently driven by an increase in the number of Utahns abusing two particular legal opioids, fentanyl and oxycodone. Between 2009 and 2012, casualties linked to these two drugs jumped by 20.6 for fentanyl and 8.9 percent for oxycodone; the increase in deaths caused by oxycodone products is especially disturbing, given the tremendous amount of publicity surrounding the hazards associated with this class of medication. But for some reason, Utah’s citizens have been slow to get the message, as casual attitudes toward prescription drug abuse have continued to persist.

The Utah Department of Health has released data about the circumstances involved in the state’s prescription drug deaths. It found that 73 percent were directly correlated with a substance abuse problem, while physical health problems and mental health problems were implicated in 68 percent and 65 percent of these deaths, respectively. There is a significant degree of overlap here, which suggests that most people who develop addictions to prescription drugs start out on a legitimate prescription and only slip into dependency over time. Opioid painkiller addiction in particular is a stealth disorder of the first magnitude, and the citizens of Utah have obviously been underestimating the risks these drugs carry for quite a long time.

Where Awareness Is Lacking, Prescription Drugs Are Attacking

Utahns, even those who belong to the church and observe LDS principles judiciously, clearly perceive prescription drugs differently than other intoxicating substances. When they first begin to misuse opioid painkillers, for example, it likely never occurs to them that they might end up addicted even though rates of addiction for these drugs have skyrocketed.

The organizers of the “Use Only as Directed” campaign are doing their best to spread the word about the dangers of prescription drug abuse on their website and through radio and TV ads. But old habits die hard, especially old habits of thinking. Between 2007 and 2010, the first burst of publicity about the problem was impactful enough to reduce prescription drug fatalities in the state by almost 30 percent. However, with rates of decline stalling, it is painfully clear that much more work needs to be done to alert Utahns to the grave risks associated with prescription medication abuse.

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