Valley doctors are writing fewer opioid prescriptions. Is it enough to curb crisis?

A major court judgment against a drug company and reports of a multi-billion dollar settlement being negotiated by another pharmaceutical company has drawn nationwide attention about addictive pain-relieving opioid drugs.

In the central San Joaquin Valley, where almost 1,000 deaths have been blamed on overdoses of prescription narcotics over the past decade, doctors are generally writing fewer prescriptions at a lower rate than they were 10 years ago.

Since prescription rates per 1,000 residents peaked earlier this decade, the number of prescriptions for opioid narcotics such as hydrocodone, oxycodone, codeine and others in the five Valley counties are down by as much as 24.7 percent.

Hydrocodone is sold under multiple brand names including Vicodin, while oxycodone is sold as OxyContin, Percocet or Percodan, among others.

Still, with between 560 and 660 prescriptions being written each year for every 1,000 residents in Fresno, Kings, Madera, Merced and Tulare counties, the state Department of Public Health reports prescription rates in the region outpace the statewide rate of about 500 prescriptions per 1,000 people.

In Fresno County alone, almost 644,000 prescriptions for opioid narcotics were written for patients by their doctors last year, filled either through pharmacies or administered in hospitals or medical clinics. That’s part of almost 24.4 million prescriptions statewide in 2018.

Why does it matter?

In the Valley, the past 10 years have seen 1,131 opioid overdose deaths, 974 of which were related to prescription drugs.

From 2008 through 2018, California reported 21,765 deaths attributable to overdoses of opioids. The deadliest year was last year, when 2,311 deaths were related to opioid poisoning, the state health department reported. Of those, nearly 1,700 were from prescription drugs.

California is among a number of states taking pharmaceutical companies to court for allegedly flooding the market with addictive painkillers and contributing to thousands of overdose deaths. The state filed suit in June against Purdue Pharma, the manufacturer of OxyContin, alleging the company used “unlawful practices in the marketing, sale and distribution of opioids.”

Last month, federal agents targeted another big pharmaceutical company, McKesson Corp., and its facility in West Sacramento, after the U.S. Drug Enforcement Administration scoured its regulatory databases and discovered that over the past two years, McKesson was the largest distributor of oxycodone and hydrocodone in the state.

A warrant was based on what the DEA called “suspicious orders” of narcotics since 2006. It sought records on how the company distributes the highly addictive drugs.

The attention and concern over overdoses from prescription drugs reached a new peak last week after a judge in Oklahoma issued a $572 million judgment against Johnson & Johnson for its role in the distribution and marketing of the narcotics. That ruling at the conclusion of a six-week trial came after two other companies, Teva and Purdue Pharma, opted to settle with the state.

Purdue Pharma is reportedly negotiating a settlement believed to be worth $10 billion to $12 billion to settle lawsuits across the country. Attorneys general in 48 states and hundreds of local government agencies have lawsuits pending against drug companies, blaming them for being at least partially responsible for an opioid epidemic that has fueled nearly 100,000 deaths from overdoses nationwide in 2017 and 2018.

In recent years, the U.S. Centers for Disease Control and Prevention have urged physicians to be aware of the potential for patients to develop addictions to prescription opioids.

The message seems to be getting through. Just as the number of prescriptions being written by doctors in California have fallen, so to has the volume of opioid narcotics shipped by drug manufacturers and distributors to pharmacies, hospitals and medical practices after rising steadily for years.

The Sacramento Bee and The Associated Press contributed to this report.
Lifelong Valley resident Tim Sheehan has worked in the Valley as a reporter and editor since 1986, and has been at The Fresno Bee since 1998. He is currently The Bee’s data reporter and covers California’s high-speed rail project and other transportation issues. He grew up in Madera, has a journalism degree from Fresno State and a master’s degree in leadership studies from Fresno Pacific University.