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Prescription Drugs

How the fight against prescription drug abuse changed Georgia law

Dallas Gay and his grandson Jeffrey

Dallas Gay and his grandson Jeffrey

Dallas Gay of Hall County began to see things in a new light in 2009, when he discovered that his grandson had a serious drug problem.

It was the nature of the drug that was especially surprising. Jeffrey Gay’s demon was not crystal meth, crack, or some other illicit substance. He was hooked on legal painkillers – drugs that doctors prescribe millions of times each year for their patients.

His grandfather immediately began looking for resources in Hall County, but found that preventing or treating this type of substance abuse was barely on anyone’s radar.

“No one seemed to be aware of how serious the epidemic was,” says Dallas Gay, 73.

National statistics show that drug-related deaths have been rising for the past 20 years, and today more people die from prescription drug overdoses than from car crashes.

The CDC estimates that nearly 2 million Americans abused prescription drugs in 2013, and that 44 die from opioid overdose each day.

Gay estimates that Hall County loses about 25 people a year to prescription drug overdoses, or about two each month.

The Gainesville resident’s search for information about this type of substance abuse led him to two prominent health care professionals in the city  –  Dr. Jack Chapman, an ophthalmologist, and Dr. Tennent Slack, an anesthesiologist and pain specialist.

Gay and the two physicians launched a public education campaign they called “Think About It,” emphasizing simple steps to help prevent medication abuse. The guidance includes taking medications as prescribed; not giving leftover pills to a friend; and disposing of medications at a secure site, i.e., one that is not in the household or public garbage.

In 2011, the three persuaded the Medical Association of Georgia Foundation to take the “Think About It” campaign statewide. This public education effort was a natural for an organization of physicians, says Lori Murphy, who develops new programs for the foundation. Doctors want to help people understand that opiate drugs are designed to relieve overwhelming pain, not for casual partying.

 

Protecting the protectors

 

Prescription Drug AbuseWhen an overdose causes someone to become unresponsive and stop breathing, that person’s companions often don’t call 911 because they’re afraid of getting into legal trouble themselves. This is especially true of teenagers.

Such inaction is tragic, because nowadays prompt treatment can save the lives of many overdose victims. One particular drug, naloxone, has shown good results in this area.

Naloxone (sold as Narcan) is a medication that reverses opiate overdose when given as an injection or used as a nasal spray. “It has the potential to save the life of someone who is virtually at the point of death,” says Gay.

Gay and others interested in addressing the problem in Georgia lobbied hard to pass the “911 Medical Amnesty/Naloxone Law,” which Gov. Nathan Deal signed a year ago.

The law provides limited legal immunity to intoxicated minors who seek help for themselves or others in drug-use situations. It also provides amnesty to anyone who prescribes, issues or administers naloxone to a person who appears to be overdosing.

Jeremy Sharp, a junior at the University of North Georgia, was actively involved in lobbying for the amnesty law. Since the law went into effect less than a year ago, prompt use of naloxone has reversed 229 life-threatening overdoses, he says.

 

Loss and grief

 

Unfortunately, Gay’s grandson Jeffrey did not live to see the law take effect.

In 2012, after nearly two years of sobriety, Jeffrey relapsed and died of an overdose of prescription drugs. He was just a month shy of his 22nd birthday.

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Had the amnesty law been in place at the time, and had Jeffrey’s friends known what to do in his final crisis, he might still be alive today.

Dallas Gay is a retired president of Protein Products, Inc., which produces catfish ingredients for pet food and feed industries. He remains as passionate as ever about trying to prevent deaths caused by misuse of prescription drugs. His next campaign focuses on putting naloxone in the hands of more police officers and educating first responders about proper first aid for someone who has consumed too much.

The Medical Association of Georgia Foundation is focusing on health care consumers, emphasizing that unused medicines need to be disposed of properly and securely. According to Gay, more than 70 percent of people who abuse prescription drugs get them through friends and family.

The family medicine cabinet may be an irresistible temptation for a young person looking for a cheap high.

As Lori Murphy says about recreational use, “A lot of kids think that they’re invincible, and they’re not.”

 

 

 

Rebekah Ryan, born and raised in Hall County,  is currently seeking a master’s degree in public relations from the University of Georgia.

 

Health literacy: Many patients don’t understand what their doctors mean

Health literacy is becoming a Georgia priority — though there’s still plenty of room for improvement.

Health literacy is becoming a Georgia priority — though there’s still plenty of room for improvement.

The state’s schools of medicine, nursing, public health, dentistry, pharmacy and education, as well as community organizations, are all working on improving people’s ability to understand health information so they can make good decisions about their medical care.

An estimated one in six adults in Georgia do not have sufficient health literacy.

In a Pharmacy and Therapeutics journal interview, Dr. Ruth Parker of Emory University said that “many people can’t read and understand and act on a medicine label, so we’ve started thinking: ‘What is it that we’re asking them to do, and [then asking] how good a job are we doing?’ ”

Poor health literacy among the public is the kind of weak link that can undermine even the best health care system.

Laura Hauser of DeKalb Public Library’s Literacy Services says, “We cannot assume that most people today fully grasp what health care professionals are trying to convey when giving directions and explaining medications or medical procedures.”

Health literacy is a particularly low among the poor and uneducated. But it is not simply an issue of reading ability, nor is it necessarily based on a person’s IQ. Research shows there are people from all ages and backgrounds — and all income and education levels — who run into problems because they’re unable to understand their own medical information.

The consequences can be very serious. When hospitals have to readmit patients they’ve already discharged, it’s often because poor communication caused patients to not maintain the proper care  once they got home.

According to the American Medical Association, “individuals with limited health literacy incur medical expenses that are up to four times greater than patients with adequate literacy skills.”

The economic burden of poor health literacy is estimated at $106 billion to $240 billion per year in the United States. It’s far too high a price to pay in terms of dollars, but more importantly, the human toll is staggering.

 

The reasons behind the rules

Take a fictional patient, Jack.

Jack’s prescription says: “Take one pill twice a day.” But he works nights, and his schedule is harried. So he swallows both pills at night to avoid taking the second one in the morning, when he may be tired and forget. That short cut may seem more convenient than following the directions exactly, but it’s a bad idea.

For many medications (such as digoxin), it’s important to maintain a certain level of the drug in the bloodstream around the clock. Otherwise the medicine may not work properly. So ignoring the instructions and taking the whole daily dosage at once is counterproductive and even unsafe.

No one explained that to Jack, or it wasn’t explained clearly. His lack of knowledge may make him the next medical emergency.

Even though he didn’t understand its importance, the language of Jack’s prescription was clear. But in some medical situations, patients are confronted by terminology they simply don’t grasp. And nowadays many Georgia residents are not native speakers of English.

Georgia has well-documented health disparities and high rates of chronic medical conditions that can be exacerbated by an inability to understand directions.

“We all are working on messages that tell people what they need to do, where to get help, and empower them to ask questions — and then deliver these messages at the point of care,” explains Kara Tarantino, director of marketing at Georgia-based Vericom Corporation, a company that focuses on health messaging. “People need information that’s easy to act on.”

Health care instructions can be tough to understand. But the rules and provisions of health insurance can be downright bewildering. And things may get worse, at least for a while, once the federal Affordable Care Act is fully implemented in January.

Attention to the readability of health documents and medication labels is critical.

“Readability is of immense importance, but so is the clarity of face-to-face interaction,” says Don Rubin, professor emeritus with the University of Georgia’s Center for Health and Risk Communication. “The trick is never to lose sight of all communication needs, even amidst all the complexity and crises of medicine.”

Research shows that patients who take part in their own health care decisions are more likely to get better faster.

Patients should speak up and say, “I don’t understand,” if the information is too complicated or is explained in terms that are meaningless to them. Every person should have the ability to receive, think about, and understand the treatment and care they will be receiving, experts say.

 

Judi Kanne, a registered nurse and freelance writer, combines her nursing and journalism backgrounds to write about public health. She lives in Atlanta.

 

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