Oklahoma opioid commission outlines steps to save more lives
Opioid deaths are down in Oklahoma from their peak in 2013, but much of the heavy lifting remains to be done.
The Oklahoma Commission on Opioid Abuse, led by Attorney General Mike Hunter, had its first meeting on Tuesday. Medical providers and state officials gave commission members a broad overview of efforts to reduce overdose deaths and other consequences of opioid misuse.
The rate of overdose deaths in Oklahoma has fallen 25 percent since 2013, and fewer young people are misusing prescription drugs, said Terri White, commissioner of the Oklahoma Department of Mental Health and Substance Abuse Services. Some of the progress came from equipping police and emergency medical technicians with naloxone, a medication that can reverse an opioid overdose. About 120 lives have been saved with naloxone since 2015, she said.
Oklahoma still had the 10th-highest rate of overdose deaths in 2014, however, White said.
“The state reacted and is starting to make a difference. We just have a long way to go,” she said.
Reducing the death rate further probably is going to require some major investments by the state and by medical providers, she said.
Oklahoma has underfunded mental health and substance use treatment for years, and the state doesn't have enough beds available for people who need inpatient treatment, White said. She estimated 600 to 800 people are waiting for a bed every day, with spots allocated to the people believed to be most in need.
“While people have been on our waiting list, we've seen them arrested, we've seen DUIs and we've seen them overdose,” she said. “Everyone who hits that list is in need or they wouldn't have met the medical criteria.”
Don Vogt, who manages the prescription management program at the Oklahoma Bureau of Narcotics and Dangerous Drugs, said the state also needs to commit funding to its prescription database. The database currently relies on federal grants, but those may not hold out, he said.
The database notifies providers if a patient gets painkillers from more than one doctor, but it could be more valuable if staff could do more to verify the data, educate doctors and track ways that drugs get into the wrong hands, Vogt said.
“Research is critical to identifying problems before they get out of hand,” he said. “Right now, I can tell you what's going out of a pharmacy or doctor's office. I can't tell you what's coming in.”
Providers also could help by reducing the number of pills available for misuse if they switched away from paper prescription pads to electronic prescribing for opioids, White said. The U.S. Drug Enforcement Agency used to have strict rules about electronic prescribing for opioids, but relaxed those after it became clear patients could more easily alter or copy a paper prescription, either for themselves or to sell, she said.
Unfortunately, electronic medical record systems may not be set up to prescribe opioids, so doctors would have to put money into upgrading their systems, White said.
“It sounds really simple, but it's not. It's expensive,” she said.