Despite an increase in prescriptions, the number of tightly controlled drugs being dispensed in West Virginia is on pace to drop to its lowest amount in five years, according to a report presented to state lawmakers Monday.
"The number of prescriptions aren't dropping off like the number of pills are," said Mike Goff, who administers West Virginia's Controlled Substances Monitoring Database. "They're writing more prescriptions, but it's for shorter duration. So it's less pills in the medicine cabinet and into the hands of patients who could potentially do something wrong with it."
In 2011, West Virginia pharmacies dispensed 295 million doses of drugs classified as controlled substances - medications like opioid painkillers, anti-anxiety drugs and amphetamines. By the end of this year, that number is expected to decline to 268 million pills, a 9 percent drop over five years.
"It's declining rapidly," Goff said.
Hydrocodone - sold under brand names such as Lortab and Vicodin - saw a 40 percent drop over those years. In October 2014, the federal government reclassified highly addictive hydrocodone products from schedule III narcotics to schedule II, which comes with more restrictions. The change aimed to curb prescription opioid abuse.
West Virginia's decline in hydrocodone prescribing mirrors a national trend. A federal study released in late January found that the Drug Enforcement Administration's decision to reschedule the painkiller led to 1.1 billion fewer hydrocodone pills being dispensed in the U.S.
During the past five years, the number of oxycodone pills has remained unchanged, while the painkiller tramadol increased by 30 percent in West Virginia, from less than $1 million pills in 2011 to a projected 38 million tablets by the end of this year.
The number of prescriptions written in West Virginia is expected to top 5 million by the end of the year. That number is the highest it's been since 2013.
"Instead of a 30-day prescription for 180 or 240 opioid pills, they're writing a 15-day supply and cutting it in half," Goff said.
West Virginia regulators started cracking down on rogue pain clinics two years ago. The state has shut down or denied licenses to a dozen clinics. State lawmakers recently passed legislation that aims to close loopholes that clinic operators were using to skirt state inspections.
The state pharmacy board also now tracks physician prescribing practices and overdose deaths.
A review panel has sent nearly 8,600 letters to doctors and other medical professionals about patients who see multiple doctors for prescription opioids - a practice known as "doctor shopping."
The panel also has reviewed 1,500 drug overdose deaths and sent 125 notices to doctors about their patients dying because of an overdose, Goff said.
The pharmacy board next plans to notify doctors about overdose survivors by including that information in a statewide database, which physicians are expected to review before writing a prescription for painkillers.
"That may be a talking point with the patient at the very least," Goff said.
Goff presented the report to a joint House-Senate health committee Monday during legislative interim meetings.
Reach Eric Eyre at ericeyre@wvgazettemail.com, 304-348-4869 or follow @ericeyre on Twitter.