Prescription drug abuse and opiate addiction in Texas are the focus of a report prepared by the Trust For America’s Health (TFAH). TFAH describes itself as a non-profit, non-partisan organization “dedicated to saving lives by protecting the health of every community.” Opiate addiction has spread like wildfire throughout the country. TFAH promotes prevention of addiction through protection—accountability and action—and through community action.
Statistics on Opiate Addiction in Texas
Right now, what guesses would you make about the money that Texas spends through its Health Resources and Services Administration? TFAH lists the amount of money per person that each state spends—which is the known as the per capita amount—and Texas ranks 46th out of 51, including Washington D.C. It spends $16.99 per person on health resources and services, not just for drugs but for all epidemiologic purposes. Texas is bordered by New Mexico ($39.73), Oklahoma ($20.01), Arkansas ($26.48), and Louisiana ($34.40), figures from 2014 that were made available for consumer edification late in 2015. Compare that against the total cost of drug addiction to the U.S. economy. It’s running at $53.4 billion. That includes $2.2 billion spent on criminal justice costs and $944 million allocated for medical complications of addiction.
Texas was one of five states (the others are California, Illinois, New York, and North Carolina) with the highest numbers of Medicaid beneficiaries possibly involved in fraudulent purchases of prescription drugs, most notably contributing to opiate addiction in Texas. The majority of beneficiaries suspected of perpetrating this fraud visited the same six to ten practitioners within the state.
Texas ranked well among the other states in terms of the number of people dying from opiates. Opiate addiction in Texas killed 9.6 people per 100,000 people, putting it at number 43 on the list. West Virginia had the most deaths per 100,000 people at 28.9; North Dakota ranked best at only 3.4 deaths per 100,000 people.
The mortality rate from drug overdose dropped significantly. Between the years 1979 and 2010, there was an increase in overdoses of 336 percent. But excluding those first 20 years brought the rate down to 78 percent. Only 16 states ranked better.
How many people died from motor vehicle deaths, compared with deaths from opiate addiction in Texas? The TFAH tells us only that the motor vehicle death rate of 13.4 was greater than the overdose death rate. In many states the overdose death rate is higher.
State Prescription Report Card
There are 10 indicators used to measure a state’s level of progress in the war on opiate drugs. Texas appears to rank pretty well, unless you scrutinize a couple of them closely. For reporting purposes, the total number of states is 51 and includes Washington, D.C. On paper, at least, Texas succeeds in 9 out of 10 areas:
- Texas and all the other states have laws against doctor shopping—hence the statistics available that possibly ten of all the doctors in the state are distributing the most prescriptions.
- Texas is among 22 states that require its prescribers to become educated about prescribing opiates and alternative ways of managing pain.
- Texas is one of 49 states that utilize a prescription drug monitoring program (PDMP). PDMPs allow physicians and pharmacists to look at a person’s history of filling opiate prescriptions.
- In Texas as well as 44 other states, prescribers cannot order a prescription pain medication unless they have completed a physical exam on the patient.
- Texas is one of 32 states that require patients to show identification before they receive prescription pain medication at pharmacies. The big failing here is that the law states pharmacists are permitted to ask for identification—but there’s no requirement to do so.
- Texas is one of 47 states that utilize lock-in programs for potential opiate medication abusers. That means if a person is identified as a frequent recipient of opiate prescriptions they are locked into one pharmacy for filling those prescriptions. In Texas, there are about 100 patients who are locked in because they attempted to utilize two or more emergency departments, or visit at least four pharmacies, with a minimum of 10 controlled substance prescriptions, within a 90-day period. Actually, Texas checks off the box for compliance with this parameter, but we have to question why only a paltry 100 people out of almost 27 million people in the huge state of Texas are locked into this program.
- Texas was among 26 states that did not expand Medicaid when the Affordable Care Act was passed. It means that people without the ability to pay for private health insurance have no state-level assistance in paying for opiate addiction in Texas. However, there are Medicaid funds available to pay for methadone treatment—but not for Suboxone or Vivitrol treatment. This is technically a plus in the fight against opiate addiction in Texas—but just barely.
- In Texas, you can take advantage of Naloxone, aka Narcan, a drug that is being distributed in many other states to first responders so they can treat opiate overdoses immediately, before they become fatal. Republican Representative Timothy Burgess keeps pushing for passage of such legislation—and he actually believes it should be approved as an over-the-counter medication. It’s also notable that he was a physician before he was a state senator.
In spite of the fact that Texas meets nine of the 10 criteria, it seems rather important that Texas misses in these two areas of huge importance:
- Whether or not prescribers actually follow through with utilization of the data available from PDMPs is questionable because Texas is one of 34 states that do not make PDMPs mandatory. Identification of opiate addiction in Texas is optional, it seems.
- Texas has not passed a Good Samaritan law guaranteeing immunity for anyone who reports a possible overdose or fatality related to opiate addiction. In Texas, this includes people who access naloxone. Expect to get arrested if you ask for help and you are found to be in possession of narcotic drugs.
Finding a Program for Opiate Addiction in Texas
The state identifies programs that provide help for opiate addiction treatment in Texas as Narcotic Treatment Clinics (NTCs). State laws require treatment providers to address these areas for their clients:
- NTCs must provide services that improve an individual’s ability to function.
- They must help their clients find a way to make positive lifestyle changes.
- NTCs must document that they reduce the amount of illicit drug use in their communities.
- They must also develop community partnerships that will deter drug-related criminal activity.
- They must decrease the incidence of infectious disease related to opiate addiction in Texas, including HIV/AIDS, tuberculosis, hepatitis B and C, bacterial infections, and sexually transmitted diseases.
- They must help their clients work toward employment or vocational education goals.
You can also find a three-page directory of Narcotic Treatment Clinics in Texas, arranged by clinic name. You’ll have to use the Control+F function on your computer keyboard to find the programs located by city—or just run your eye down the list. If you’ve been considering the many ways a treatment program can change your life, then your next step is calling an NTC in your community and asking how you can get help.