BY KATRINA HEDBERG
He was a star high school athlete from Astoria who aspired to be a tugboat pilot. But Jordan Strickland started using prescription opioids, which ultimately ended his promising life in a fatal heroin overdose in July 2015. As she reflected on his tragic story, Jordan's mother, Kerry Strickland, regretted the lack of information and support available to her family. "Nobody," she said, "was talking about heroin and prescription pills."
Two years after Jordan's death, the number of lives lost - young and old, rural and urban, affluent and impoverished - continues to mount across the nation. States have struggled to stay ahead of the problem.
Oregon is no exception. But state health officials have been working with doctors, health plans (and coordinated care organizations), patient groups, researchers and others to tackle this complex problem in a new, multi-pronged way.
First, the bad news. More of us now know someone -- a family member, a friend or someone in our wider social circle -- struggling with prescription opioid addiction.
As Lynne Terry reported in her recent story on opioid abuse ("Oregon leads U.S. in seniors hospitalized for opioids," July 7), our state has a high rate of hospitalization for opioid abuse among seniors. Oregon has particularly high rates of opioid overdose deaths in rural parts of the state, which is in line with a recent Centers for Disease Control and Prevention report that found larger amounts of opioids are prescribed in the nation's rural counties. Oregon also suffers one of the highest rates of non-medical use of opioids, especially by young adults like Jordan.
For state health experts, our focus has been, and will continue to be, on curbing opioid misuse and abuse no matter where it occurs in Oregon, no matter the age or income-level of the families who are affected.
The Oregon Health Authority convened health care partners, policy makers, advocates and academics to settle on a common strategy to reduce deaths, non-fatal overdoses, and harms to Oregonians from prescription opioids, by expanding pain care without the use of opioids.
Oregon's strategy is based on a four-pronged approach:
- Improve pain treatment for patients. Help patients find effective alternatives to opioids, which reduce pain without risk of addiction. These alternatives include physical therapy, chiropractic care, massage, acupuncture, cognitive behavior therapy and exercise.
- Increase the availability of treatment for people suffering from opioid addiction and expand access to rescue medication to treat overdoses.
- Change physician-prescribing guidelines to reduce the amount of opioids in the community, and encourage safe drug storage and drug disposal.
- Collect data to better understand the opioid abuse problem in Oregon and target interventions to help people get the support they need.
The good news: Our efforts in Oregon are starting to pay off. Opioid prescribing is down for all age groups since January 2016. Drug overdose hospitalizations for prescription opioids are declining. Drug overdose deaths due to prescription opioids are down.
Why? Fewer opioids are being prescribed, which has resulted in fewer opioid overdoses and fewer people becoming addicted to prescription pain-killers. Substance use treatment, as well as naloxone rescue medication, has helped people overcome abuse and prevent fatal overdoses.
We are making progress, but we have a long way to go. It will take the combined efforts of health care providers, families and neighbors, community leaders and partners to change the way we think about the tide of prescription pain killers flooding our communities -- and further action -- to stem their damage. We owe that commitment to people like Jordan Strickland, his mother and everyone in Oregon whose lives are altered by opioids, no matter their age or background.
Katrina Hedberg, MD, is the state health officer and epidemiologist at the Oregon Health Authority, Public Health Division.