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BY AARON LECLAIR/LBEDIT7@LARAMIEBOOMERANG.COM •
FRIDAY, SEPTEMBER 28, 2012
Painkillers, sedatives, antidepressants and other commonly prescribed drugs are supposed to help people overcome pain, to heal and to become whole again.
While these drugs are effective if used in the prescribed amounts, some are highly addictive and dangerous if used in large amounts or combined with alcohol or other drugs.
In Albany County, as in many other jurisdictions, prescription drug-related deaths are on the rise with no end in sight.
Albany County Coroner Kathleen Vernon-Kubichek participated in a panel discussion at the Wyoming Prescription Drug Abuse Forum’s “When Prescriptions Kill” conference at the University of Wyoming on Sept. 21.
As county coroner, Vernon-Kubichek is responsible for investigating the causes of all human deaths in Albany County due to accidents, violence, suicide or unknown causes.
Since she took office in January 2011, Vernon-Kubichek said all fatal drug overdoses have been accidental and involved prescription drugs.
“In both of these years, there have not been any illegal drug overdoses,” she said.
In addition, all of the fatal drug overdoses in Albany County since January 2011 have involved multiple substances.
“There’s not someone just overdosing on benzodiazepines (sedatives) or on OxyContin,” she said. “They’re all a combination of drugs — most likely a combination of drugs and alcohol.”
In 2011, prescription drugs were involved in every single death in which drugs were factor.
“Sometimes, it would be a combination of legal and illegal drugs,” Vernon-Kubichek said. “But, in every case, there were prescription drugs.
“By and large, these are drugs people are being prescribed and are legally obtaining,” she said. “These are not, necessarily, sold on the street.”
This year, fatal overdoses involving prescription drugs are three times higher than they were at this time last year, Vernon-Kubichek said.
From January to September 2011, 10 percent of non-natural deaths were the result of fatal drug overdoses involving prescription drugs.
From January to September 2012, 30 percent of non-natural deaths were the result of fatal drug overdoses involving prescription drugs.
In fact, by the end of March, the county coroner’s office had investigated as many prescription-drug fatalities as it had in all of 2011.
However, while the increase in the rate of fatal overdoses involving prescription drugs is alarming, Vernon-Kubichek noted that the numbers are relatively small compared to a much larger community.
“We’re not working with a huge amount of deaths here,” she said. “We have 75-100 deaths a year, so a handful can change your numbers quite a bit.”
Pain relievers, sedatives and sleeping aids are some of the usual culprits in fatal drug overdoses, especially when some are combined with other drugs or alcohol.
“I would say hydrocodone (a painkiller) is No. 1, then benzodiazepines,” Vernon-Kubichek said. “Really, it’s the combination of a painkiller and a benzodiazepine like hydrocodone and valium.”
In many cases, what happens is a person takes their prescription drugs, drinks alcohol, goes to bed and dies in their sleep, Vernon-Kubichek said.
Less commonly is the scenario in which a person takes so many pills he or she, literally, drops dead.
“They are deceased before the hit the ground,” Vernon-Kubichek said.
Tricyclic antidepressants are also involved in fatal overdoses, Vernon-Kubichek said.
“They have a narrow therapeutic range,” she said. “The difference between one dose and two or three doses can be the difference between therapeutic (effects) and coma or death.”
Prescription drugs-related deaths are not the sole providence of troubled teenagers. Vernon-Kubichek said they include people of all ages, races and socioeconomic backgrounds.
One reason why the number of fatal overdoses involving prescription drugs has been rising is the practice of doctor and pharmacy shopping, Vernon-Kubichek said.
“You can get a prescription here … and two days later go down to Colorado and get a similar prescription filled,” she said. “We see that quite a bit.”
Another reason is a person who has been on a painkiller or benzodiazepine for a long time needs more of the drug for the same therapeutic effect, sometimes bordering on a non-therapeutic level.
“It’s a lot of people in their 40s and 50s who have been taking these kinds of drugs for a while,” Vernon-Kubichek said, “and sort of pushing the limit and then, finally, crossing over that threshold.”