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Razor’s Edge Prescription drug abuse in rural states now a leading cause of deaths, arrests and treatment admissions by Margaret Nagle

Razor's Edge

Thirteen years ago, when Dr. Margaret Greenwald came to Maine to be the state’s chief medical examiner, she thought she’d found, in her words, paradise. Maine’s 34 drug-related deaths a year were a fraction of what she saw in the San Francisco Medical Examiner’s Office.

Then the epidemic began.

Within five years, the number of drug-related deaths in Maine had jumped fourfold. From 1997–2002, there were 374 drug-related deaths in Maine, most due to accidental overdose.

More than 90 percent of all the drug deaths, including suicides, involved prescription drugs.

“It was a frightening thing to see deaths increase at such an alarming pace and we weren’t really seeing a lot of public knowledge about what was happening,” says Greenwald. “People were talking about OxyContin issues in Washington County and drugs coming across the border, but the fact is this was not just a local problem. It was happening throughout Maine.

“It was not marginalized citizens with illegal drugs, but it was crossing into all categories of people. It involved our neighbors and friends. That’s why we felt we needed to show them data. We needed to figure out a public health approach.”

In 2001, with funding from the Maine Justice Assistance Council and state Office of Substance Abuse, Greenwald and University of Maine medical and forensic anthropologist Marcella Sorg began to compile data on the relationship between substance abuse and drug-related mortality in the state. The next year, their landmark report became what then Attorney General Steven Rowe called “the foundation upon which to build future drug abuse policy” in Maine.

It also escalated an ongoing effort by researchers at UMaine’s Margaret Chase Smith Policy Center to track the epidemiological trends of prescription and illicit drug abuse in Maine. Those researchers in the center’s Rural Drug and Alcohol Research Program are led by Sorg, who specializes in health policy, particularly as it concerns public health, public safety, and the investigation of death and injury.

Drug Deaths 2009 - 179 Drug Deaths; 165 by Rx NarcoticsBecause of her expertise on the escalating abuse of prescription medications in rural states, Sorg has testified in recent years before Maine legislative and U.S. Senate committees, and presented her findings to state and federal agencies. The Smith Center’s pioneering epidemiological research has provided an important perspective on prescription drug abuse and mortalities in rural states — a frame of reference previously overshadowed by the war on illicit drugs in urban areas.

Sorg is now an invited member of the Community Epidemiology Work Group, a task force assigned by the National Institute on Drug Abuse to monitor national drug trends.

“(Prescription drug abuse) really is an epidemic and it appears to be a problem that is mirrored nationally as well as in other rural states,” says Greenwald. “It’s pretty overwhelming when you see the statistics and realize how pervasive the problem is.”

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Fall 2010

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