West Virginians are more likely than residents of other states to mix anti-anxiety medications with prescription pain pills - a potentially deadly combination, according to a new report from the federal Centers for Disease Control and Prevention.
For one of every five days West Virginians were taking a painkiller, the same people also were taking an anti-anxiety drug like Xanax, the CDC reported. West Virginia had the highest rate of overlapping prescriptions among the eight states taking part in the study.
"If you mix the two, that leads to most of the drug-related deaths," said Mike Goff, administrator at the West Virginia Board of Pharmacy. "The combination really slows down the respiratory system. You shouldn't mix them, especially in high doses."
West Virginia has the highest prescription-drug overdose death rate in the nation. President Barack Obama visited Charleston on Oct. 21 to spotlight West Virginia's problem with prescription drugs and heroin.
The CDC also reported that West Virginians are more likely to receive extra-strength prescription painkillers - long-acting oxycodone and hydrocodone - as new patients. More than 43 percent of West Virginians picked up such prescriptions, even though they didn't have a prescription for a less-potent opioid drug the previous 60 days or longer.
"Giving out a big dose of opioids to someone who hasn't had them is a problem," Goff said. "It could potentially lead to an overdose, if they prescribe too much all at once."
Rogue pain clinics have issued many of the high-dose painkiller prescriptions in West Virginia, Goff said. Over the past year, state health regulators have shut down some of the clinics as part of a statewide crackdown on prescription drug abuse.
For its report, the CDC used prescription data from 2013 - before the state started inspecting pain clinics.
"If you go into a pain clinic, the bad ones are just going to hand you a big 30-day prescription right off the bat," Goff said. "It's someone who walks in to the doctor, and they just hand them an opioid prescription."
The CDC analyzed prescription data from eight states - West Virginia, California, Idaho, Louisiana, Maine, Ohio, Florida and Delaware - that agreed to take part in the study.
Louisiana had the highest prescribing rates for painkillers and anti-anxiety drugs. West Virginia had the second-highest rates for both drug classes.
The CDC also reported on prescriptions for stimulants, such as amphetamines. Among the eight states, only California had a lower rate for stimulant drugs than West Virginia.
West Virginia had a comparatively low rate of residents who solicit prescriptions for controlled substances from multiple doctors - a practice called "doctor shopping."
"If you compare us to the other states, we're not way over-prescribing," Goff said. "Some things we're low on. Some things, we're higher."
The CDC said the study shows there's an urgent need to overhaul doctors' prescribing practices, particularly for painkillers, which were prescribed twice as often as stimulants and sedatives in West Virginia and the other seven states.
Overall, the study found that a small percentage of doctors was responsible for most opioid prescriptions.
Every day, 44 people die in the United States after overdosing on prescription pain pills, according to a CDC news release about the study.
"A more comprehensive approach is needed to address the prescription-opioid overdose epidemic, including guidance to providers on the risks and benefits of these medications," said Debra Houry, director of the CDC's National Center for Injury Prevention and Control.
Reach Eric Eyre at ericeyre@wvgazettemail.com, 304-348-4869 or follow @ericeyre on Twitter.