Prescription drug deaths no longer setting records

Pinellas County Commissioner Susan Latvala says the battle against prescription drug abuse is not over.

Record levels of deaths from prescription drug deaths are no more in Pinellas County.

District 6 Medical Examiner Dr. Jon Thogmartin conveyed the good news to Pinellas County Commissioners, who approved the contract with the medical examiner’s office for another year during their Sept. 11 meeting.

Thogmartin said regulations put in place by the County Commission and enforcement efforts by the Sheriff’s Office to combat prescription drug abuse had worked.

“Prescription drug deaths are mostly gone,” he said. “It’s quite wonderful.”

Asked if heroin deaths were on the rise, Thogmartin said “not really.”

“After prescription drugs go away, it looks like a lot, but it is not really up or maybe a little bit,” he said. “We’re back to traffic accidents and the usual stuff.”

The medical examiner’s office first noticed a dramatic increase in drug-related deaths in 2006. The numbers spiked 28 percent that year – from 169 deaths caused by drugs or toxins in 2005 to 216 in 2006. That year also was when the office noticed that there were more drug-related cases than those from deadly car crashes.

The trend continued. In 2010, prescription drugs in Pinellas County alone accounted for 22 percent more deaths than all fatal vehicle crashes reported in both Pasco and Pinellas counties.

Pinellas County was No. 1 in the state for the number of deaths due to an overdose from prescription drugs. The county also was No. 1 in the number of babies born with an addiction to opiates.

Pill mills – places where doctors handed out prescriptions by the handful – were blamed for the problem, as were those who doctor-shopped in an effort to get more drugs for themselves or to sell for money.

Commissioners approved the county’s first moratorium on pain management clinics in 2010, preventing any new clinics from opening. In addition, regulations required existing clinics to register and follow basic standards. Clinics that did not register were shut down.

The ordinance was scheduled to expire at a date certain after the state legislative session ended, as commissioners had hoped the state would enact laws regulating prescription drugs. The state did not take action.

In 2011, commissioners voted to extend the moratorium another year – again in anticipation of state action. The title of the ordinance was changed from pain management to high prescribing health clinics and a minimum of 34 prescriptions a day was set as the threshold that defined a high prescriber.

By 2012, prescription drug deaths had decreased by nearly 30 percent, going from 249 in 2010 to 175 in 2012.

In 2012, the moratorium was extended again, as the commission continued to wait on the state. The minimum number of prescriptions written a day to define a high prescribing clinic was reduced from 34 to 20.

The moratorium was extended yet again in 2013. Despite a slight decline in annual deaths, 175 to 172, the Prescription Drug Advisory Board recommended the extension due to continued concerns about “high prescribing activity.”

Commissioners will consider another one-year extension at a public hearing on Thursday, Sept. 23, 6 p.m., in the fifth floor assembly room of the Pinellas County Court House, 315 Court St., Clearwater.

No action was taken by the state during the 2014 session, so commissioners want to continue the moratorium until 60 days after the close of the 2015 session.

Staff also recommends amendments that would remove some reporting requirements, include measures to secure digital prescription pads and allow doctors to renew registrations so practices can be bought and sold.

Commissioner Susan Latvala, chair of the Prescription Drug Advisory Board, said at last count, the county had 23 registered high prescribing clinics.

She said the state had failed to take action to regulate prescription drugs. She said the moratorium should be extended.

“I strongly support the moratorium,” said Commission Chair Karen Seel, who thanked Latvala for her leadership. “We’ve heard from Dr. Thogmartin about what a difference it has made.”

Latvala said the state was planning to try a private service to run the prescription drug database, which is supposed to help identify doctor shoppers or other suspicious activity.

But, doctors aren’t required to use it, she said.

“The battle is not over,” Latvala added.