Congressmen hear scope of Oregon’s prescription pain pill problem

In a roomful of pedigreed professionals and U.S. legislators, she told her tale of addiction.

Three years ago, she was on the streets. Caitlin, who didn’t give her last name, said she held a sign asking for money and shot up heroin. She went to sleep hungry and woke up cold. She didn’t expect to live long. She never expected to have a family.

But she found help through a nonprofit, CODA, and today, at 27, is heroin and cigarette-free. She has a healthy baby boy, an apartment and hope.

Caitlin was the success story at a meeting Tuesday at Lines for Life, a nonprofit in Southwest Portland that works to prevent addiction and suicide. Heading the table were three U.S. legislators from Oregon: Sens. Ron Wyden and Jeff Merkley, both Democrats, and U.S. Rep. Earl Blumenauer, D-Portland. The session, with doctors, public health professionals and insurers, focused on the overuse of prescription opiates.

In 2012, Oregon led the nation in the nonmedical use of pain pills in terms of the number of pills dispensed per capita, according to the Oregon Public Health Division.

“Let’s be very clear here: Opioid addiction has hit Oregon like a wrecking ball,” Wyden said. “We are going to be dealing with this for years and years.”

Kerry Strickland has been wrestling with her family’s tragedy for months. In July, her son Jordan died from a drug overdose just days from his 25th birthday. Living in Knappa on the Oregon Coast, Jordan partied with friends in high school. They crushed and snorted pills. At 17, the star athlete turned to heroin.

He died after going through recovery five times.

“The disease of addiction is very powerful,” Strickland said.

Often it’s not addressed as both a physical and mental issue, said Dr. Alisha Moreland-Capuia, an addiction psychiatrist and medical director of Volunteers of America.

“Relapse is high,” she said.

About 70 percent of heroin overdoses in Oregon start with prescription pain pills, Merkley said.

Emergency room doctors see the wreckage first hand, with patients pleading for help to get off pills, said Dr. Sharon Meieran, an emergency physician.

“We’re canaries in the coal mine,” Meieran said.

Everyone at the table agreed that Oregon has a problem. Some asked the legislators for help in Congress. Others pointed out changes that need to be made at home.

Take the Oregon Health Plan, the state’s Medicaid program. It pays for pills for chronic pain but doesn’t cover physical therapy or acupuncture.

That doesn’t make medical or financial sense, said Dr. Amit Shah, a medical director of CareOregon, which insures health plan patients. His organization decided on its own to cover alternative treatment for chronic pain.

“The return on investment is enormous,” Shah said.

And yet there are few studies showing what alternative treatments work best and for which patients, or how to wean patients off high-dose prescriptions, said Dr. Roger Chou, a professor at Oregon Health & Science University.

“The evidence is lousy,” Chou said.

There’s a growing movement across the country against prescription pain pills. Some worry the pendulum might swing too far, with doctors refusing to treat patients for chronic pain. There’s also a problem of stigma. 

“Addiction is a disease, not a moral failing,” said Dr. Paul Lewis, health officer for Multnomah, Clackamas and Washington counties. “We’re all susceptible to it.”