Campbell County sees a 55% decrease in pain medications written in 2019

With all of today’s uncertainty in our lives, sometimes it’s OK to take a break and look back at things we have accomplished.

August 31, the world observed International Overdose Awareness Day, a day to remember without stigma those that have died and acknowledge the grief of their family and friends, according to their website. This is a somber topic for sure. But in Campbell County, Wyoming, we have made significant strides in the past decade, and we should recognize the providers who have contributed to this accomplishment.

In 2011 the Centers for Disease Control (CDC) county-by-county opiate prescription map showed that Campbell County prescribed 90 opiate prescriptions per hundred people per year. That’s almost one pain medication prescription for every person in the county. But since 2011, the clinical science has become clearer that the use of daily chronic opiate therapy lacks substantial evidence in the medical, scientific literature.

This is not “settled science” (I believe that science should never be settled) but our current understanding of daily pain medications is that the body gets used to it after a few weeks, and the only persistent effect is to make the user apathetic about their pain, while stimulating the brain’s pain center. This well-studied phenomenon, coupled with electronic prescribing made it easier to see how many people die each year due to overdoses, and has caused us to examine the risk and benefits of long-term daily pain medications more carefully.

In 2019, the United States drug overdose death total was 70,360, an age-adjusted rate of 21.6 per 100,000, an over 250% increase from 1999’s 8.2 per 100,000 people. After the intense marketing of drug companies in the 1990’s and 2000’s we prescribed a lot more back then.

But ultimately no one got better from their chronic pain and many people died. So, by 2016 the CDC issued new guidelines on prescribing pain medications. In Campbell County, most prescribers were already aware of the opioid crisis and were prescribing much more judiciously. Counter-intuitively, more careful prescribing in a smaller community is tougher than a big city, as our connections here to our patients are much closer. They are our neighbors, friends, fellow church members and the parents of our kids’ friends. Saying “no” is harder.

By 2019, Campbell County had decreased its opiate prescribing to 40 opiate prescriptions per hundred people a year, a 55% decrease in pain medications written here since 2011. This has undoubtedly saved lives.

Each patient deserves a thorough evaluation to understand their unique problem, and providers who offer safe and effective solutions. To those Campbell County providers who fulfilled this duty but felt that long term daily pain medication prescriptions was not the answer, thanks for making our county healthier and safer.

Article was written by John Mansell, MD, Campbell County Health Chief of Medical Staff and Wyoming Society of Anesthesiologists President.