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Oregon's Programs Fall Far Short on Opioid Crisis, Audit Finds

An audit by the Secretary of State's office found that Oregon's drug monitoring program allows for drug-seeking behavior, dangerous combinations of different drugs for single patients, and insufficient treatment for those in recovery.

Posted: Dec 11, 2018 3:55 PM
Updated: Dec 11, 2018 4:29 PM

SALEM, Ore. — Despite nationwide sound and fury over the opioid crisis, Oregon is nowhere near closing the gap on their corner of the problem, a recent audit by the Secretary of State's office found.

"The audit found that Oregon lags behind other states in implementing many best practices, and it recommends much needed solutions," the Secretary of State's office said in a statement on Tuesday.

The Cost of the Opioid Crisis (from the SoS' Office)

  • Oregon has the highest rate in the nation of seniors hospitalized for opioid-related issues such as overdose, abuse, and dependence.
  • The median cost for each hospitalization due to opioids is $13,000.
  • In 2016, almost 500 pregnancies were complicated by maternal opioid use and 280 infants were born with Neonatal Abstinence Syndrome.
  • From 2015 to 2017, 314 more children entered foster care due to a parent’s drug abuse.
  • The state also has the sixth-highest percentage of teenage drug users.
  • Many people who are severely addicted also find themselves incarcerated at some point.

According to the audit, more than 4,000 people were recently prescribed a potentially lethal combination of three drugs — opioids, benzos, and muscle relaxants — within the same month. One person received 1,545 days' worth of zolpidem, a prescription commonly used as a date-rape drug, from five different prescribers in one year.

Almost 150 Oregonians got ahold of controlled substance prescriptions from "30 or more separate prescribers" and filled those prescriptions at 15 or more pharmacies within a three-year period.

"On average, every three days an Oregonian dies due to prescription opioids. While opioids can be helpful in addressing pain with appropriate medical oversight, they are highly addictive. Dependence on prescription opioids can occur in less than a week, and taking a low dose prescription of an opioid for more than three months raises the risk of addiction 15-fold," the Secretary of State's Office said.

“The findings from today’s audit are clear and disturbing: Oregon has an opioid crisis, and not nearly enough is being done to protect individual Oregonians and their families from this epidemic of suffering. It is unacceptable that this tragedy had been compounded by ineffective, duplicative, and even nonexistent regulation and protection. Oregonians throughout the state have been affected, and too many have paid with their lives," said House Republican Leader Representative Carl Wilson (R-Grants Pass).

The solution, as Secretary of State Dennis Richardson sees it, is a Prescription Drug Monitoring Program (PDMP) that actually works. While all 50 states have a PDMP of some form or another, Richardson says that Oregon's program has been knee-capped by legislation [see graph, right]. Many neighboring states have far more effective programs, according to Richardson.

“Many opioid deaths are preventable, but [Oregon Health Authority] OHA is trying to fight this crisis with one hand tied behind its back,” said Secretary of State Dennis Richardson. “Oregon should learn from the experiences of other states and follow the best practices being successfully implemented across the nation. This audit identifies solutions to save lives and money.”

The Secretary of State's office claims that Oregon's PDMP collects far less information than neighboring states, and "it is used less effectively." PDMPs are typically used to collect information on opioid prescriptions and those of other powerful drugs, tracking histories from patients healthcare providers and pharmacies.

"The Prescription Drug Monitoring Program is a critical tool that needs significant upgrades in order to most effectively fight the opioid crisis,” said Audits Director Kip Memmott. “This audit maps out a way to better address opioid and other substance abuse issues.”

The Secretary of State's office says that they have made 12 recommendations to the Oregon Health Authority (OHA) for improvements, including the following:

 - Ensuring all key prescribers are required to register and to use the PDMP

 - Sharing data with the state’s Medicaid program

 - Providing guidance on integrating use of the PDMP database

 - Identifying and proposing drugs of concern, ensuring prescription information is complete

 - Working with the legislature to expand laws to allow for more data analyses and sharing

 - Collecting more information

 - Requiring prescribers to use the PDMP database

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