- The Washington Times - Wednesday, July 12, 2017

Three Southwest Virginia towns are among the top five jurisdictions with the highest number of opioid prescriptions per capita in the nation, a new report says.

Martinsville, Virginia, topped the list, having doled out nearly 4,090 morphine milligrams equivalent per capita in 2015, according to a report by the federal Centers for Disease Control and Prevention. Norton City, Virginia, was second, with 3,374 morphine milligrams equivalent per capita.

Galax, Virginia, ranked fourth, with 3,119 morphine milligrams equivalent per capita.

The average milligrams equivalent for the nation in 2015 was 640.

William A. Hazel Jr., Virginia’s secretary of health and human resources, told The Washington Times there isn’t a sole explanation as to why the southwest has been hit so hard by what is a nationwide opioid crisis. But one major cause could be the region’s struggling economy, coupled with high numbers of disabled residents.

“In areas of the country where there has historically been a heavy labor component — and there’s a significant disability that goes with that — individuals may lose their employment for whatever reason,” Mr. Hazel said.

“Martinsville has had a lot of the furniture industry leave. Southwest Virginia has had the coal issues down there. A lot of the heavy-duty employment is gone. When people have injuries and they don’t have a place to go, they get caught in a sort of complex where you earn your living simply by being disappointed,” the health secretary said.

The addiction problems are not limited to the southwest part of the state, however. Last year, the number of Virginians who died from an opioid overdose hit 1,100 — a 33 percent increase over 2015 — and reported visits to emergency departments statewide totaled more than 10,000.

In November, Virginia’s health commissioner declared a public health emergency. Since then, Gov. Terry McAuliffe has signed four bipartisan bills with initiatives aimed at counteracting the epidemic.

The measures include opioid prescription policies and increased access to naxolone, an overdose-reversal drug. Virginia emergency medical volunteers have reported that they successfully used naxolone more than 4,000 times last year.

At a summit in May with D.C. Mayor Muriel Bowser and Maryland Gov. Larry Hogan, Mr. McAuliffe noted a law he had recently signed that limits physicians to a seven-day prescription maximum.

“We are looking at prescribing patterns, because sometimes it can be just a person or a group of people that are inappropriately prescribing,” Mr. Hazel told The Times. “Sometimes it’s cultural: A region may just tend to prescribe more pain medication.

“When you look at Virginia numbers, addiction numbers are different depending on area,” he said. “What is unique about Southwest Virginia, for instance, is that addiction is still related to prescription medications — perhaps at a higher percentage than other areas. That may speak to the availability of the pills that are put on the street.”

Earlier this year, Martinsville emergency room physician Richard Perren confirmed that to a local news station.

“The trend in medicine is to back off in terms of chronic pain,” Dr. Perren noted. “So a lot of patients who have had chronic pain or who had issues with chronic pain are having difficulty finding their narcotics, and, as a result, they’re using medications that come from the street.”

During May’s summit, Mr. McAuliffe declared his intent to find out which doctors have been overprescribing painkillers.

“We need to know when folks are doctor-shopping,” he said. “We need to have knowledge, and then we need to hold doctors accountable.”

Mr. Hazel said the solution to the statewide and nationwide problem is multifaceted. People suffering chronic pain need to realize they can be helped without narcotics, he said.

“But we need to find a way to not pass judgment on those who are addicted and are in recovery. There needs to be a way to welcome them back,” he added. “They need a place to live, they have to get a job, they have to have support. Otherwise they will be back in harm’s way. It’s that simple.”

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