It’s easy for Washington residents to obtain, take their pain medicine

Unlike several other areas of the country, painkilling medicine is widely available throughout Washington state to people suffering from chronic or acute pain and who have received prescriptions, according to a new survey of the state’s pharmacies.

More than 90 percent of the responding outpatient pharmacies carry a broad supply of long-acting and short-acting opioids, or morphine and morphine-like medicines, said Jonathan Mayer, a University of Washington professor of epidemiology, geography and medicine and the lead author of a new study. In addition, the study found little difference in the availability of prescription pain medication between rural and urban areas, between poor and more affluent neighborhoods, or between minority and predominantly white neighborhoods.

These findings contrasted sharply with earlier studies conducted in New York City and Michigan. The New York City study showed that 51 percent of pharmacies had inadequate stocks of painkillers to serve patients in severe pain. The shortages were concentrated in poorer areas and those with large minority populations. The Michigan study revealed a significantly lower availability of the medicines in areas with high minority populations.

The new study looked at the availability of such medicines as Vicodin, Lortab, Percocet, OxyContin, Methadone, Demerol, morphine, Dilaudid and codeine, which are used in post-operative pain management as well as for a variety of conditions ranging from cancer and herniated disks to sprained ankles.

Mayer and his colleagues contacted all 1,349 outpatient pharmacies in Washington and more than 800 filled out surveys. The researchers found that virtually all of these commonly prescribed painkillers were available from at least 90 percent of the responding pharmacies. The only exceptions were Dilaudid and codeine, which could be found at 86 percent and 77 percent, respectively. Codeine is rarely prescribed alone.

He noted that there is still a controversy about how habit-forming these medicines can be. He said that the risk of drug dependence when they are used to treat pain has been vastly overstated, and people who do develop some dependence can be tapered off their medications slowly.

“What was surprising to us was that there was no difference in the availability of these medicines between rural and urban areas and in poor and more affluent areas. Generally rural and poor areas have less access to aspects of health care,” said Mayer.

"We can only speculate why the availability of these medicines is so different than in New York City and Michigan. The culture of the medical community here in addressing pain may be one of the notable differences, and physicians in Washington may be more willing to prescribe strong pain medication in Washington than in New York City or Michigan.

The University of Washington was the pioneer in having a multi-disciplinary pain center, and has been teaching appropriate use of pain medicines since the 1950s. Pain Center members have been some of the foremost leaders in understanding and treating pain There also may be less fear of robbery by pharmacy owners here than in the Bronx or Brooklyn" he said.

The study appeared in February’s issue of the Clinical Journal of Pain and was funded by Purdue Pharma, L.P., which makes the painkillers OxyContin and MS Contin. Co-authors of the study are Dr. John Loesner, a UW professor of neurological surgery and anesthesiology, and former UW graduate students Beth Kirlin and Colin Rehm.