OMAHA -- Nebraska doesn’t have the level of opioid problems other states do, but it needs to take action to fight the epidemic of painkiller addiction, officials said Friday.
“We are ahead of you,” Wisconsin Attorney General Brad Schimel told more than 300 people at a summit on Nebraska’s response to opioid abuse.
Prescription opioid painkillers have become a common remedy for chronic pain, and abuse has led to an epidemic of accidental overdoses.
More than 14,000 people died of prescription opioid overdoses in the U.S. in 2014, according to the most recent Centers for Disease Control data.
Wisconsin, home to 5 million people, experienced a 500 percent increase in its opiate overdose death rate between 2000 and 2013, Schimel said.
Nebraska’s overdose death rate has climbed, but it still ranks among the lowest in the nation.
Nebraska Attorney General Doug Peterson, Nebraska's U.S. Attorney Deborah Gilg, the state Department of Health and Human Services and the University of Nebraska Medical Center hosted the summit to try to stem the tide.
Doctors, drug investigators and public health officials said Nebraska must confront the abuse in terms of prevention, treatment and enforcement.
“If all you do is focus on one piece, you will not succeed,” said former Florida Surgeon General and Secretary of Health Dr. John Armstrong.
Both Armstrong and Schimel commended officials here for taking proactive steps to address the problem.
Wisconsin’s problem languished for years before law enforcement and the medical community formed a coalition to take it on.
When Schimel took office in 2014, the exploding rate of overdose deaths needed to be addressed, he said.
“What if we saw traffic deaths increase like this?" he asked. "We would do crazy things. We’d put a roundabout every 200 feet.”
Feeding the problem, Schimel said, Wisconsin had an abundance of prescription pills on the street, which was evident during law enforcement takebacks.
In 2014, the takebacks collected 34,000 pounds of pills, he said. In April, they collected 64,000 pounds.
That made Wisconsin No. 3 in America for drug takebacks, and the state collected just 200 pounds less than California. Wisconsin has 5.7 million people, California, 38 million.
Some of it came from over-prescribing, Schimel said.
When Wisconsin implemented its prescription drug monitoring program, 50 percent of doctors surveyed said they never looked at it, he said.
Lawmakers there changed the law so more doctors would use the monitoring program, and the state focused on making more of them able to prescribe Suboxone, which helps treat opioid addiction.
Once voluntary, Nebraska’s prescription drug monitoring program will require dispensers to enter and track all prescriptions for controlled substances including opioids beginning in January.
Increasing the number of physicians in Nebraska who can prescribe Suboxone may help expand services in a state where the only methadone treatment centers are in Lincoln and Omaha, officials said.
States like Nebraska have also directed prescribers not to view opioids as the first option to treating chronic pain, officials said.
Instead, they're asked to consider massage and physical therapy and to prescribe anti-inflammatory drugs.
At Dr. Tom Tape’s office in Omaha, adopting the new CDC guidelines to treat pain has already led to positive effects, he said.
Tape saw fewer emergency room visits and fewer positive screenings for depression.
Fewer patients reported frustration over drug refills, and patient knowledge of the risk of opioids and dependence increased, he said.
“It’s so much easier to stop this problem before it starts,” Tape said.
While Armstrong and Florida health officials went after and closed 600 pain clinics, he also wrote letters to federal regulators expressing concern with the manufacture of a particular brand of hydrocodone he believed was ripe for abuse.
State leaders must not be afraid to express their concerns with the pharmaceutical companies, Armstrong said.
A group focusing on Nebraska's response to opioid abuse will meet next month to discuss next steps, Peterson said.
It does the country no good, Schimel said, if one state tackles the problem and its neighbor doesn’t.
The drug will find a way in, he said.
“We have to solve this as a nation,” Schimel said