Balance, Pain

How does PPSG’s State Report Card relate to opioid associated deaths?


Can you find the correlation?

About Pain policy & palliative care

Improving global pain relief by achieving balanced access to opioids worldwide

Discussion

2 thoughts on “How does PPSG’s State Report Card relate to opioid associated deaths?

  1. Jim,

    As you know, I would argue that your grading system for states is unbalanced since the scale only moves in one direction… That is, states can get a low grade for policies that are too restrictive, but a state with lax restrictions can get an “A”.

    So, this comparison is very interesting. Looking at a relationship between consumption and state grades probably makes more sense than comparing deaths to grades, since many people who die from ODs struggled with the disease addiction, sometimes for many years, before they died.

    Andrew

    Posted by Andrew Kolodny | November 9, 2011, 9:46 PM
  2. Dr. Cleary,

    I would have to agree with Andrew I don’t think there is much of a correlation between state grades and the rate of deaths per state. With the exception of KS, TX and VA who receive an A on the PPG grading system (2008 assessment) and have the lowest deaths per 100,000 (and the lowest amount of opioids per 10,000) – the eleven states with the highest death rates per 100,000 – six had a B or B+ and five had a C or C+ and five had the highest amount of opioids per 10,000.

    In places like Florida and Kentucky I think we can point to access – folks driving 14 hours one way from KY to buy opioids in FL at pill mills and returning to sell in KY, which probably explains the higher death rates in surrounding states to FL. Florida a state until recently with a non-existent PMP and a grade of B and Kentucky with what is considered one of the best PMPs in the country and a grade of B both with the highest death rates per 100,000.

    Another contrast is my own state, PA which has a non-functional PMP and high death rate and a C+ grade compared to UT which has a great PMP program (now in 2011), a B+ grade in 2008 and a high death rate in 2008. It would seem that deaths have to do with access/availability and lack of clinician tools (PMPs) or poor utilization of clinician tools (PMPs).

    The other piece of the drug overdose data that we don’t know is how much of this is due to the significant increase in the use of Methadone for pain by clinicians poorly trained in complex P’Col & PK of this drug. And one final point – how many of these overdose deaths were due to multiple substance ingestion and not just due to opioids?

    Jim

    Posted by James B. Ray | November 10, 2011, 12:00 PM

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