Most of our U.S. emergency rooms are witnessing an increasingly large number of fatal overdoses due to prescription opioids like Vicodin and OxyContin. These outnumber overdoses of cocaine and heroin combined, according to a recent blog post. Thomas Frieden, CDC Director, says we have an epidemic of opioid overdoses in the U.S. Last year alone we averaged nearly 40 deaths a day, which totaled 15,000 deaths from prescription overdoses.

Frieden believes the majority of blame should lie with the few U.S. physicians that prescribe these types of painkillers too loosely, either from greed or out of a lack of knowledge. One CDC report found that 3 percent of doctors were responsible for over 60 percent of opioid prescriptions in California alone related to workers’ compensation beneficiaries. 48 states have already passed legislation to set up prescription drug management programs with the only two hold outs: Missouri and New Hampshire. Already in Oklahoma when an opioid has been prescribed, it is entered in the system within minutes under the recipient’s name.

Overall, researchers in the study, including Lynn Webster, MD, and peers from the Lifetree Pain Clinic based in Utah, said patients using methadone saw emergency room visits at rates 23 times greater than patients using hydrocodone. Methadone can be administered as a prescription medication for pain, or as a prescription included in an opioid drug recovery program. Researchers said the majority of the fatalities linked to methadone were connected to the drug’s use as a pain medication.

The recent study, published in Pain Medicine, also said that methadone calls to poison control centers were ten times greater than calls for the prescription painkiller oxycodone and several times higher than calls for hydrocodone. Methadone is a man-made narcotic that entered the pain-treatment market in the U.S. in 1947. As the drug has become more accessible to treat both pain and drug addiction, numbers of abuse have also risen.

In nearly one-third of all deaths related to overdose where an opioid drug was involved, researchers said methadone was involved- even though the drug accounts for a percentage less than five percent of the prescription opioid painkillers given in the U.S. Webster and colleagues believe the fatalities related to methadone overdosing may be connected to doctor’s giving incorrect dosages or not being aware of safe methods for regulating the drug. Additionally, patients may increase their chances for overdose or death if they combine methadone with alcohol or other painkillers and anti-anxiety medications.

Because several elements can contribute to methadone overdoses and deaths, researchers said the answers to the growing problem must also be multi-faceted, including patient education, physician education and looking closely at usages of the drug that are not medical in nature. Part of the physician educational element, say the researchers, should include helping doctors learn ways to screen and manage patients who meet criteria for prescription opioid pain management. Additionally, more research is called for to explore more closely ways to pre-identify patients who may be at higher risk for abusing methadone and opioid-based painkillers.

Due to the possibility that patients may also have co-existing mental health disorders that can escalate chances for prescription drug misuse, such as depression or anxiety problems, a careful assessment of any existing mental health problems should be part of physicians’ considerations when prescribing methadone or opioid painkillers, say study authors.

A 23-year-old man was sentenced to 20 years in prison recently by a judge in Georgia in connection with a fatal heroin overdose. Warren Ullom, singer with the Atlanta-based rock band “The Judies,” had pleaded guilty to voluntary manslaughter in the death of 32-year-old Rachel San Inocencio. Ullom was also convicted of possession and distribution of heroin and cocaine.

The circumstances surrounding the death take it out of the realm of mere “accidental” overdose and make it something entirely more sinister. Actions taken by Ullom that fateful day not only exacerbated San Inocencio’s already precarious position, but may also have prevented her from getting life-saving treatment.

On June 6, 2008, just days after the couple met, San Inocencio and Ullom shot heroin at Ullom’s apartment; San Inocenico became ill shortly thereafter and lost consciousness. Instead of calling 911, Ullom texted one of his friends and told him to bring over some cocaine to help revive San Inocencio. When his friend arrived with the drugs, Ullom proceeded to inject the fallen woman with two doses of cocaine. Upon leaving the apartment, Ullom’s friend called 911, but didn’t give the dispatcher the correct address. In the mean-time, Ullom sent the friend another text indicating that San Inocencio was feeling better and didn’t need an ambulance.

San Inocencio died thirty minutes later and was pronounced dead by emergency workers who responded to Ullom’s own belated 911 call. Ullom stashed the remaining coke in San Inocencio’s purse and told unsuspecting police officers to take it with them when they collected the body. To make matter’s worse, Ullom later pawned San Inocencio’s diamond earrings.

Ullom had originally been charged with felony murder, which carries with it a mandatory 30-year minimum sentence. However, he later pleaded guilty to a lesser offense. His lawyer claims that the heroin dealer who sold Ullom the drugs was the party responsible for the tragedy.

In anticipation of his incarceration, the singer and his band played farewell performances, made a DVD, and recorded some additional songs.

Ullom’s case, however, pales in comparison to the story of Carly and Andrea Townsend. In 2008, Carly’s mother, Andrea, was found guilty of manslaughter due to neglect in the death of her teenaged daughter after failing to call emergency personnel when Carly overdosed on heroin. Carly’s twenty-six year old sister, Gemma, was also charged in the crime.

During the trial, Andrea Townsend claimed that Carly’s lips briefly turned blue after taking the heroin, but that they eventually returned to normal color. Townsend also claimed that Carly was mumbling, and thus, not in any danger. Townsend was downstairs watching TV while her daughter was passed out upstairs, but insisted that she “listened” from the living room door a number of times and heard her snoring. Townsend refrained from calling an ambulance for fear that she or her daughter would get in trouble.

Sixteen-year-old Carly had been taking drugs for two years and had recently been released from a juvenile detention center into her mother’s care. It was revealed that 20 of Carly’s friends had recently died from heroin overdoses.

http://www.ajc.com/news/atlanta-rocker-convicted-in-544100.html?cxntlid=thbz_hm

http://www.walesonline.co.uk/news/wales-news/2008/04/18/mother-of-drug-overdose-girl-found-guilty-of-manslaughter-91466-20782361/