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Good news on Iowa overdose deaths: Fewer cases in 2 years

December 9, 2016

(Des Moines Register/Tony Leys)  Iowa got a rare piece of good news about heroin and pain-pill abuse Thursday: The number of Iowans dying from overdoses of those drugs has dropped significantly in the past two years, after spiking to record highs over the previous decade.

The state's top expert believes the use of overdose-antidotes is helping stem the tide of such deaths.

The number of pain-pill overdose deaths jumped from 11 in 2003 to 77 in 2013, then fell to 42 in 2014 and stayed down at 43 for 2015, according to a new report from the Governor’s Office of Drug Control Policy. The number of heroin overdose deaths quadrupled from five in 2009 to 20 in 2013, then fell to 15 in 2015, the report shows.

Iowa's encouraging results ran counter to a national trend. A new report from the Centers for Disease Control and Prevention shows heroin overdose deaths continuing to jump, from 10,574 in 2014 to 12,990 in 2015. Overdose deaths from prescription painkillers rose slightly nationally, from 16,941 to 17,536.

Steve Lukan, director of the office, said he wondered a year ago if the sharp drop in narcotics overdose deaths was a statistical blip. Thursday’s report suggests the decline is a solid trend, he said. “But certainly, there remain big challenges,” he said.

Lukan said the decline in narcotic overdose deaths doesn’t prove fewer Iowans are abusing the drugs, also known as opioids. He said the explanation probably includes increased training and experience among emergency medical responders and police officers, who know how to recognize and respond to overdoses. Also, more first responders are now carrying antidotes, such as naloxone, which can reverse the effects of a narcotics overdose before a person dies. Those medications are about to become even more available, as the state announced recently that pharmacies soon will be able to sell them to relatives and friends of drug abusers without a prescription.

Lukan also said many physicians have been trying to limit prescriptions of addictive painkillers to patients who might be abusing them. For example, he said, an increasing number of doctors are using the state’s prescription-drug monitoring system, which allows clinics and pharmacies to check whether patients asking for painkillers have already received similar prescriptions elsewhere.

Edward Bottei, medical director for the Iowa Poison Control Center, cautioned against being too excited about the trend. "Even though the deaths are down, the problem is still there," he said. By historical standards, overdose deaths remain very high, he pointed out.

Bottei wants to see health-care professionals become even more careful about prescribing painkillers and other addictive drugs. He applauded national guidelines released recently by the CDC, advising doctors on how to treat pain without feeding addictions. Public-education efforts about pain pills also must continue to be strengthened, he said. "We need to counter the perception that because it's a prescription drug, it can't hurt you. We know from all these deaths that yes, it can hurt you."

Both experts noted that many people who become addicted to opioid pills often migrate to cheaper heroin. Lukan added that law-enforcement officers have made significant busts of heroin rings, but so far, they have been unable to rein in the illicit market for that street narcotic. “We’re reluctant to say it’s harder to get than it was a few years ago. It’s probably easier to get,” he said.

The new state report also shows a disturbing increase in the number of Iowans showing up at hospital emergency rooms with marijuana-related problems. That number hit 166 per month in 2015, four times what it was a decade earlier. Lukan speculated the trend was due to much stronger strains of marijuana and increasing ease of access to the drug.

The report has some good news, however. For example, the state overall has the second-lowest rate of illicit drug use, behind only South Dakota.

Also, the number of high-school juniors drinking alcohol or smoking tobacco has dropped by nearly half in a decade. Lukan credited effective public education and law enforcement. “In those areas, everybody seems to be on the same page, and we’re seeing results,” he said.

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