CHARLESTON, S.C. (WCSC) - Recently released data from the Drug Enforcement Administration painted a shocking picture of the number of opioids distributed in the Lowcountry. The numbers revealed that Charleston County, on average, gave out more pain pills than anywhere else in the country from 2006 to 2012. However, more recent statistics show an improving trend with opioid prescriptions across the Palmetto State.
Over the course of four consecutive years, South Carolina saw a decrease in opioid prescriptions from 2015 to 2018, according to data from the SC Department of Health and Environmental Control.
Charleston County also saw a decrease. In 2018, it had the third lowest number of pills distributed per person in the state.
It’s an improvement from the alarming rate that caused Charleston County to lead the nation in pain pill distribution from 2006-2012, according to DEA data.
Between those years, Charleston County had an average of 248.3 pills distributed per person per year. The Washington Post called the data, “a virtual road map to the opioid epidemic."
The data showed the VA’s mail order pharmacy in North Charleston was responsible for the largest portion of those pain pills in Charleston County.
According to the data, 512,414,034 pills were supplied by the pharmacy center between 2006 and 2012.The next highest number came from an unspecified Walgreens location on James Island, which distributed 3,836,900 pills.
However, officials with the Department of Veterans Affairs countered that conclusion.
“Comparing a consolidated mail-order pharmacy that fills prescriptions for more than 200 VA pharmacies across the nation to standalone, neighborhood pharmacies such as Ken’s Thriftee Pharmacy in Walhalla, South Carolina – as the Washington Post is attempting to do – is like comparing apples to oranges,” DAV spokesperson Jan Northstar said. “Since then, VA has been recognized by many as a leader in the pain management field for the responsible use of opioids, and the department is sharing its knowledge and experience with federal and local governments and across the nation’s health-care networks.”
According to the DAV, 52 percent fewer patients are receiving opioids and 58 percent fewer patients are on long-term opioid therapy.
Officials say these results have been achieved during a time that the VA has seen a 6.5 percent increase in patients using outpatient pharmacy services.
“We expect even better management of pain medications for Veterans when VA and the Department of Defense roll out new, integrated electronic health records. The new records will give health care providers a full picture of patient medical history, enabling better treatment and better clinical outcomes,” Northstar said. “It will also help us better identify Veterans at higher risk for opioid addiction and suicide, so health care providers can intervene earlier and save lives.”
MUSC Health surgeon Mark Lockett said he was surprised by Charleston County’s opioid distribution rate when he first saw the numbers from the DEA.
“When I saw the numbers, the volume of pills just didn’t make sense at all, even though the opioid problem has been a major problem, it still was way above what you would normally expect,” Lockett said.
He believes numbers from the VA’s mail order pharmacy skewed the picture the data had painted of Charleston County.
“We are prescribing more than we should, but those numbers are a little bit misleading. Charleston County is not the worst in the country,” Lockett said.
However, there is an opioid problem in Charleston County.
New numbers from the South Carolina Department of Health and Environmental Control show an increase in opioid overdose deaths across the state, and Charleston County, specifically, saw an increase of about 6 percent, from 94 deaths in 2017 to 100 deaths in 2018.
Locket is working to address this epidemic with his work at MUSC.
“It starts with initial medical intervention. That’s not going to be everybody, but we can impact things by prescribing less, treating pain in different ways,” Lockett said.
Through training and awareness, Lockett has already seen results.
Surgical residents at MUSC Health are prescribing about 60% fewer opioids than their counterparts did in 2017, according to Lockett.
“Some patients stay on opioids. They do fine. It treats their pain. They have no problems. But then some of those patients, go off and start using they shouldn’t be using and are a part of the overdose statistics,” Lockett said. “We are trying to prevent that on the front end by prescribing less, identifying people who may be getting off into a misuse category, and then figuring out how to treat them, and recognizing how we can do things better so that hopefully we can stop the epidemic at the headwaters.”
Veteran doctors at MUSC Health are getting opioid reduction training, including dentists, nurse practitioners, physician assistants and nurses. The state already requires them to take at least two hours of opioid training per year. More training is in the works in the form of online courses that are about to go live at MUSC, officials said.
Lockett believes another part of curbing the opioid epidemic is educating patients about the risks of opioid addiction and informing them about other pain treatment options.
“Now the majority of our kidney transplants go home with no opioids at all,” Lockett said. “Still treat patients pain because we don’t want patients to have pain, but to do it in a way where we get similar, if not, as good or better outcomes from a pain control standpoint but not having to use the opioids that have that long term risk.”