When Indiana Attorney General Greg Zoeller learned from the Centers for Disease Control and Prevention that drug-related fatalities now outpace car accidents as the nation’s leading cause of death, he knew he had to take action.
And when he learned the true culprit behind the epidemic was sitting legally in family medicine cabinets across Indiana, he developed a plan that has led to sweeping changes in the regulation and administration of prescription drugs.
“This is not a subculture of people who live in the margins,” said Zoeller, noting that 77 percent of heroin overdose victims first became addicted to prescription medication. “These are also kids from middle and upper middle income families who may have first gotten addicted from a doctor’s prescription.”
“This is not a subculture of people who live in the margins. These are also kids from middle and upper middle income families who may have first gotten addicted from a doctor’s prescription.”
The first step taken by Zoeller to curb the state’s growing problem came in September 2012, when he established the Indiana Attorney General’s Prescription Drug Abuse Prevention Task Force, a group of roughly 100 members consisting largely of state legislators, medical professionals, educators and law enforcement personnel.
The goal of the task force, according to its website, is to “significantly reduce the abuse of controlled prescription drugs and to decrease the number of deaths associated with those drugs in Indiana.”
“I was excited to do this because I think it is important to bring people together from different segments,” said Zoeller, noting that it takes on average seven relapses before an addict can fully recover. “Collectively, we need to act because we can do more together than we can do individually.”
As Zoeller noted, working collectively has become more of a necessity than a desire in recent years. According to a study released in April 2014 by the Indiana State Epidemiology and Outcomes Workgroup, prescription drug dependence was indicated in 13.4 percent of Indiana treatment admissions, compared to the national rate of 11.8 percent.
The problem has been difficult to corral, however, as evidenced by data from the Indiana State Department of Health. In 1999, 25 people died in Indiana from overdoses related to opioid abuse. By 2013, that number had climbed to 168, and sat at 250 as recently as 2011.
To help counter the influx of prescription drugs into the hands of at-risk children and adults alike, Zoeller’s task force implemented INSPECT, which maintains a digital database of patient information for healthcare professionals, and increases certain capabilities of law enforcement in policing prescription drugs.
INSPECT’s most heavily-utilized component – the database – has done an efficient job of tracking drug prescriptions throughout the state, said Zoeller. Pharmacies, as ordered by House Enrolled Act 1218, are required to provide opioid drug dispensing information to INSPECT’s database within three days. That time limit will shrink to 24 hours starting Jan. 1.
This allows both pharmacies and law enforcement officials to recognize and target the pharmacists dispensing and addicts abusing opioid drug prescriptions. The bill also requires methadone clinics to check INSPECT before prescribing.
“INSPECT helps limit the doctor shopping,” said Zoeller. “Previously, you go to three or four doctors and get a prescription, and then you go to three or four pharmacies and get them filled. INSPECT now tracks all of the prescriptions for a patient, so if you see someone’s already been prescribed, you don’t give them another one.”
In accordance with the year’s most pressing drug topic, Zoeller’s task force also helped to implement Senate Bill 461, which allows any county in the middle of an HIV or hepatitis C epidemic to seek a syringe exchange program.
The need for the legislation became readily apparent after Scott County, located roughly 30 miles north of Louisville, Kentucky, was hit this summer with more than 170 confirmed HIV cases.
Scott County’s HIV epidemic was linked directly to the sharing of needles among addicts who were illegally abusing Opana, a powerful prescription pain medication.
In this April 2015 image, medical waste containers are stored in preparation for Scott County residents that are looking to exchange used needles at the Community Outreach Center in Austin as part of the needle-exchange program authorized by Gov. Pence.
Following a series of discussions regarding Indiana’s previous ban on needle sharing programs, Gov. Mike Pence expressed his support for the practice, laying the groundwork for Indiana’s syringe exchange program legislation.
“Unfortunately, we need to treat this as a medical, not a criminal, emergency with the needle exchanges. Until we can get past the medical emergency, we need to allow people to deal with the crisis with needle exchanges,” said Zoeller. “I know that I’ve always been a proponent of criminal justice, but they have to stand down as we deal with the epidemic.”
Other measures endorsed and enacted by Zoeller’s task force include Senate Bill 406, which allows friends or family members to administer naloxone to a person experiencing an opioid overdose, and the Yellow Jug Old Drugs program.
The YJOD program allows people to take their unwanted medication to any participating pharmacy year-round for disposal. There are currently four locations available in Indiana, according to the task force website.
While not a part of the YJOD program, officials from Howard County Recycling District, Kokomo Police Department, Howard County Sheriff’s Department and Walgreen’s Pharmacy will be accepting old prescription drugs from 9 to 11 a.m. Sept. 12, at Community Howard Regional Health.