OVERDOSE DEATHS JUMP IN INDIANA

The number of Hoosiers who died from drug overdoses increased 147
percent from 1999 to 2004, a trend driven by the growing abuse of
prescription medications, according to a new study.

The problem, experts say, has shown no sign of abating and is
expected to worsen.

"This is the new major drug epidemic for the next generation," said
Eric R. Wright, director of the IU Center for Health Policy and one
of the authors of the study "Fatal Drug Overdoses: A Growing Concern
in Indiana."

The problem, Wright said, is believed to be most serious among young
adults and adolescents who take part in "pharm" parties, where they
bring pills, throw them into a bowl and then indiscriminately grab a
handful to take.

Overdose deaths jumped from an average of fewer than one a day in
Indiana in 1999 to nearly two a day in 2004, an increase of 147
percent. That's more than 2 1/2 times the national increase; the
number of overdose deaths in the U.S. increased 57 percent during the
same period.

National studies found no significant increases in the use of illegal
drugs or binge drinking in Indiana during the period covered by the IU study.

Misuse of prescription drugs is the fourth-most serious substance
abuse problem in Indiana, Wright said, and is likely to overtake
marijuana in the next five years to become third behind alcohol and tobacco.

Wright's report calls for a greater effort to educate the public and
medical community about the dangers of legal as well as illegal drugs.

The statistics hit home in Greencastle in December when a popular
high school senior, 17-year-old Dietrich Jackson, died after
ingesting several prescription drugs at a house party after a basketball game.

Putnam County Prosecutor Tim Bookwalter said authorities were caught
off guard by the death.

"Meth had been such a big issue, we had not recognized this (as a
problem)," Bookwalter said. "Prescription drug abuse came on the
horizon so quickly, especially among young people."

Bookwalter said the allure and danger of prescription drugs are that
they can be found in almost every home.

"They (users) don't have to go out and find them from a dealer or pay
a high price," he said. "And they just don't think of those drugs
like they do cocaine, heroin or meth. It just doesn't connect with
them; they don't recognize the danger."

Charity Pankratz, who was raising her grandson, said she worried that
Jackson might succumb to the temptation of alcohol or marijuana, but
"prescription drugs didn't even occur to me."

Jackson wore a wristband promoting a drug-free life, which Pankratz
said gave her a false sense of security. According to court records,
Jackson crushed and snorted the anti-anxiety medication Xanax and
oxymorphone, a powerful painkiller, while drinking beer on the night he died.

"It's too late for Dietrich," Pankratz said, "but if the awareness
created by his death stops one kid from doing something, then that
will be a positive."

Indiana's rate of drug overdose deaths was substantially lower than
the national rate in 1999 but almost had caught up by 2004, the last
year for which national data are available, the IU report revealed.
Indiana deaths increased again in 2005, matching the 2004 U.S. rate
of one death per 10,000 residents for the first time.

From 1999 to 2005, 2,958 fatal overdoses were reported in Indiana,
including 924 in Marion and its eight surrounding counties. Marion
County accounted for 572 of those deaths.

The problem is not confined to urban areas, Wright said. The death
rate is highest in some rural areas such as Henry, Scott and Starke counties.

Wright said some users may be turning to prescription drugs as a
substitute for harder-to-find illegal drugs.

Most prescription drug abuse takes place in social settings and is
driven by fads within local communities, he said. That's why there
are pockets in Indiana where the problem is worse than in other areas.

The most-abused prescription drugs are opiates and stimulants.

Availability is a factor in the abuse of these drugs because many
people get the medications from family or friends. Oxycodone
prescriptions in Indiana, for example, nearly doubled, from 29
million dosage units in 2002 to 54 million in 2007, providing many
more opportunities for users to snatch pills from a medicine cabinet.

Prescription drug abuse is a complicated problem with no clear or
easy answers, Wright said.

"We are a pill-driven society," he said. "Drugs are heavily marketed,
and that conveys an image of safeness."

Although programs have been in place for years to address the problem
of abuse, Wright said, "it is clear, given the data, that what we're
doing is not enough."

IU's report suggests recruiting physicians and pharmacists to help
find solutions.

"We have to figure out how to get people the medications they need,
but without having large supplies when they don't need them," Wright said.

Helping patients manage pain is one of the toughest issues physicians
deal with, said Dr. Vidya Kora, a general internist who is immediate
past president of the Indiana State Medical Association and the
LaPorte County coroner.

"Pain is subjective, and there is no test to quantify it," he said.
"There is a problem if we undertreat pain, and there is a problem if
we overtreat pain. It's a very delicate balance."

The state medical association held a seminar for doctors last year
that addressed the prescription of controlled substances, Kora said.
The session covered issues related to patient evaluations,
documentation and compliance with dispensing regulations.

Kora also believes expansion of a program operated by the state Board
of Pharmacy holds some promise for reducing the number of patients
who "doctor shop," or try to get drugs from multiple physicians.

The INSPECT program initiated in 1994 includes a database of drug
prescriptions but was available only to law enforcement until 2007.
Now, doctors and pharmacists also can check on patients when they
suspect prescription abuses.

The abuse of prescription drugs has been recently identified by the
Governor's Commission for a Drug-Free Indiana as a major problem. The
commission last year distributed about $5.5 million to counties for
education, treatment and enforcement projects.

Such help is critical because an addiction to prescription drugs is
hard to fight, said David Stanley, 55, Indianapolis, a recovering
prescription drug addict who said he has been clean for 33 months.

Stanley said his habit began after he was given legitimate
prescriptions after back surgeries in the 1980s. Although his medical
need for the pills passed, he said, his psychological dependency grew.

"It doesn't matter if it's alcohol, cocaine, heroin or pills," he
said. "The one thing people need to know is that they all lead you to
the same places: jails, institutions or death."