Oklahoma Watch: Oklahoma pharmacies fill nearly 10 million prescriptions for narcotic painkillers

Oklahoma Watch is a nonprofit, nonpartisan journalism service that produces in-depth and investigative content on important public-policy issues facing the state.
BY WARREN VIETH, Oklahoma Watch Modified: February 8, 2014 at 10:28 pm •  Published: February 9, 2014
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Oklahoma pharmacies filled nearly 10 million prescriptions for narcotic painkillers and other controlled dangerous substances last year, according to newly obtained state data.

Those prescriptions — an average of 68 per patient, including refills — contained 597 million doses of painkillers, tranquilizers, sleeping pills, steroids and other controlled pharmaceuticals tracked by the state's Prescription Monitoring Program.

Nearly 16,000 medical professionals are registered to write narcotics prescriptions in Oklahoma. About 1,500 of them accounted for nearly three-fourths of all controlled substance prescriptions filled in 2013, officials said.

The statistics, provided to Oklahoma Watch in response to an open records request, also show that many medical professionals do not routinely check the PMP's online database before writing or refilling scripts. Under current law, they are not required to do so.

“The more we drill down, the more we realize that we obviously have a prescription drug problem in Oklahoma,” said Darrell Weaver, director of the Oklahoma Bureau of Narcotics and Dangerous Drugs.

“We've got to be aggressive in doing something to drive these numbers down.”

Meanwhile, the toll from prescription drug abuse continues to rise. In 2012, the most recent year for which data is available, 844 Oklahomans were killed by overdoses, most of them accidental. That's more than the 708 people killed in vehicle crashes that year.

Three out of four overdose deaths involved prescription drugs, often in combination.

The prescribing data, compiled by Weaver's bureau, provides new insight into one of the causes of Oklahoma's escalating prescription drug crisis.

It also provides ammunition to Gov. Mary Fallin and others who want the Legislature to take new steps this year to require more physician participation in the PMP.

“I think it's more likely than not that we will endorse an approach that will have an element of mandatory checks of the Prescription Monitoring Program,” said Fallin's general counsel, Steve Mullins.

“It's a pretty high priority for the governor,” Mullins said. “She's seen the data. It's affecting way too many Oklahomans. It really is tearing up families.”

Leading the list of PMP prescriptions and overdose contributors are three popular pharmaceuticals: hydrocodone, an opioid painkiller sold under the brand names Lortab, Vicodin, Vicoprofen, Norco and Tussionex; oxycodone, another opioid painkiller sold as OxyContin and Percocet, and alprazolam, an anti-anxiety drug marketed as Xanax.

Although the overdose rate from alprazolam is generally not high when used by itself, physicians say it can become lethal when combined with narcotic painkillers. Many overdose deaths involve a “cocktail” of more than one controlled substance, and sometimes alcohol.

The prescriptions filled in 2013 were issued to 142,369 patients. That's an average of 68 prescriptions per patient. Since many controlled substances require a new prescription with every refill, a patient with chronic problems would typically log 12 prescriptions per year for each controlled substance he or she receives.

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.

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