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rom Washington, D.C., head southwest into Virginia for nearly five hours and put yourself due north from Greensboro, N.C. There you will find Martinsville, Va., where more opioids were prescribed per person in 2015 than any other jurisdiction in the United States.

Clinicians in Martinsville, home to fewer than 13,500 people, prescribed almost 4,090 morphine milligram equivalents per person. The national average was 640 milligram equivalents per person.

That contrast underlines the dramatic differences in opioid prescribing across the country as health officials try to tackle a national epidemic. A report from the Centers for Disease Control and Prevention this week found that while prescribing fell nationwide from 2010 to 2015, places that prescribed the most opioids were still doling out drugs at rates six times higher than the lowest tier of communities.

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With that in mind, Martinsville still stands out. Even the jurisdictions ranked No. 2 (Norton, Va.) and 3 (Campbell County, Tenn.) on the CDC’s list trailed by comfortable margins — with about 3,375 and 3,300 milligram equivalents prescribed, respectively.

(The report generally examined data at the county level, but Virginia has a number of cities like Martinsville that are not part of counties and are viewed as their own entities in federal studies.)

Dr. Anne Schuchat, who was serving as acting CDC director until Friday, told reporters that the overprescription of opioids has led to addictions and left people vulnerable to overdoses and deaths.

That’s a pattern seen around the country, and recent state data from Virginia show how pervasive the problem has become in Martinsville.

Martinsville
STAT

In the city and adjacent Henry County, the rate of overdoses leading to emergency department visits was the highest in the state in January, at 32 per 100,000 people. Martinsville’s monthly overdose rate has fluctuated over the months, but it has generally been among the highest rates in the state.

The demographics of Martinsville also reflect some — though not all — of the factors that the CDC researchers found were associated with high levels of opioid prescriptions. Data show more opioids being prescribed in areas with more white residents, higher unemployment rates, a greater concentration of doctors and dentists, and higher rates of disability and diabetes. The researchers estimated that the factors accounted for about a third of the prescribing differences seen among counties.

Like many of the top prescribing places, Martinsville is a “micropolitan” area, essentially a big town or small city. It also has a higher unemployment rate than the average in Virginia, and a relatively high rate of people on disability. But its population is about 50 percent white and 46 percent black.

There are a number of caveats to consider. The CDC data were based on the location of pharmacies where opioids were picked up, so people who lived elsewhere but filled their prescriptions in Martinsville could have contributed to its high rate. Many counties in the country also did not have data for the CDC to analyze.

Top 10 places where opioids prescribing was highest in 2015

Jurisdictions 2010 Per Capita MME* 2015 Per Capita MME
Martinsville, Va. 5201.1 4086.9
Norton City, Va. 2647.5 3373.5
Campbell, Tenn. 2305.0 3304.3
Galax, Va. 2557.6 3119.4
Carbon, Utah 2838.0 2817.0
Walker, Ala. 4079.3 2813.3
Claiborne, Tenn. 2581.7 2807.6
Clay, Tenn. 3002.0 2797.7
Pickett, Tenn. 5542.6 2742.4
Wyoming, W.Va. 2699.8 2660.1

*MME = morphine milligram equivalents.

And from 2010 to 2015, Martinsville, like half the jurisdictions studied by the CDC, actually saw a decrease in opioids prescriptions, from 5,200 milligram equivalents per person to 4,090. And it’s likely that prescriptions have continued to fall since then.

Since 2015 — the last year the CDC had data for — the agency and hospitals around the country have launched initiatives to rein in opioid prescribing. The CDC released guidelines for prescribing opioids for pain last year, and a Virginia hospital association came out with its own plan last April. Clinicians at Memorial Hospital in Martinsville also started working to reduce prescriptions in the middle of 2016, according to WSLS, a local news station.

Representatives at the hospital as well as as the local health department were not immediately available for comment.

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  • Whoever did that study was totally off. I live in Martinsville and doctors here rarely prescribe that many opioids. The patient has to have a debilitating disease or illness with acute/chronic severe pain or either cancer. Most doctors dont just hand out opioid prescriptions. They never have. When all those” pill mill ” doctors offices began springing up in strip malls on every corner starting in Florida then near state borders into WV and all you had to do is bring cash those places had lines of people waiting to get a script. The offices would generally be opened up and ran by non medical people who would get a doctor in need of money and entice them with more money then scripts were already written and laid in stacks all the patient did was tell the doctor which they preferred and hand them between $75-$150.00 cash each time. For those individuals who were caught and arrested the reports and all the evidence usually indicated these places were making an unbelievable amount of daily cash. Some who were not caught usually were the ones who only stayed a short while then located to another town. They moved around so fast it was hard to keep track. A good doctor usually is not afraid to write a valid script as long as he documents patients status and the patient complies with tests,exams,and fills prescriptions at same place. They know when a patient is trying to get over on them. There are a few who do not. A person who is prescribed opioids should be responsible and keep their meds locked up, not share meds and not let anyone know what they take. When they do not then they are facing possible problems for everyone.

  • Whoever did that study was totally off. I live in Martinsville and doctors here rarely prescribe that many opioids. The patient has to have a debilitating disease or illness with acute/chronic severe pain or either cancer.

  • So what’s going on is
    1) sick people were going to that county because there are more Drs. & getting their prescrptions filled there
    2) now the people in pain & on disability can no longer get their pain med
    3) addicts will continue to find drugs, illegal ones.
    4) the chronic pain patients will join the many who have already taken their lives due to being unable to live with the pain
    * the CDC has been sued for lying. Why haven’t they updated since 2015? Because the stats would be that much harder to blow out of proportion?
    Props to the writer for a MUCH more balanced article than what is usually written. Such as “65,000 OD’s in the US” not mentioning that’s ALL drugs. Or “95 to 160 (I’ve read both) deaths opioid deaths a day”….
    The CDC says “6,000 opioid RELATED deaths per year”
    Which indicates polydrug use, it’s impossible to tell what actually caused the death if alcohol, other CNS depressants were present, etc AND does not distinguish between pain meds & illicit fentanyl & heroin.
    The US is probably covering up it’s part in the “heroin crisis” by creating a “opioid crisis” that focuses on prescription drugs, which less than 1% of the population die from.
    More people ARE committing suicide every day from being cut off from meds that allow them to get out of bed. Cancer & other chronic disease sufferers are suffering more painful deaths.
    The UN the WHO (World Health Organization) etc etc all say PAIN RELIEF IS A HUMAN RIGHT.
    Even the AMA has said the new blanket laws aren’t realistic.
    Prescribing someone with major heart surgery & a mimimally invasive procedure the same amount of meds is wrong, they are tired of politicians telling them how to do their jobs after spending decades in school.
    No one representing the 100 MILLION (TIME magazine) chronic pain patients has been allowed while making these laws. Why?
    If a chronic pain patient, like my friend with MS, dies with a tiny amount of pain meds in their system while committing suicide, it will be counted as a “opioid OD”.
    Thanks to the writer again for including 2/3 of the people are on disability, & other pertinent facts always left out of other articles.
    #don’tpunishpain

    • Ditto,,,”don’t punish pain,”….I would like to ask this author,,,Could u please tell me,,,how many people died or o.d. from taking thee exact amount of the medicine opiates as prescribed by their Doctor?How many died,from taking exactly thee amount as written on their bottle,,and taking their medicine as the doctors tell u,,with no other drugs,or alcohol,,as their Doctors tell them and as the bottle states,,,What is that exact figure please????thank u,,,maryw

  • Hello,
    I live in Norton, VA and studying to be a social worker here. I read a report from last year (2017) that Terry Gilgore is spending much of Virginia’s funding on Suboxone clinics. It does not state this specifically but it is labelled as “medication-assisted treatments.” I know many who are addicted to suboxone to “relieve” their opioid addiction. Has anyone else heard similar reports? Does anyone else think this is wrong? Shouldn’t we work to help these people get sober instead of replacing one addiction for another?

    • It depends if you want them dead or alive.
      Why didn’t they teach you the difference between addiction, dependence, and tolerance?
      I know the answer, the question is, do you?
      Addicts will relapse without suboxone. Suboxone gives a higher percentage (30-60% different studies due to the length of time it takes to follow an addict) of addicts a chance at being clean.
      Or staying off illicit drugs that will land them dead eventually.
      So the question is, do you care if these people live or die? Or would you rather them die over semantics, your lack of knowledge, or your judgment of right and “wrong”?

  • I agree with Susie Q. The epidemic has been going on for years. The media has masked it, like they do with other problems we have in this country. I was losing friends to opioid overdose when I was in high school over 20 years ago. The problem is the blindness. All the new implements of electronic records has just now put the epidemic on blast?!? Oh, please!! People, you fail to see the bigger picture here: The government doesn’t want rid of the opioids, they want more control over it. They want everyone to pay for their medicine now. That’s what all this boils down to. Medicaid & Medicare pays a reduced amount for pain medication. Big Pharma wants their money. They pay lobbyists big money to make a big deal out of this issue. Big Pharma doesn’t care about you! The government doesn’t care about you. Wake up, people! Smh.

  • All it really takes is a couple of nursing home with residents on fentanyl patches. The whole concept of MME is totally flawed, but you wouldn’t know it from reading this ‘article’… sensationalism at its finest

  • Bro, you could have at least credited me for my photograph you found on flickr… Quality work, n’est çe pas?

  • A while back I went to the ER. Out of nowhere I started to have a pain in my right arm. Hadn’t hit it or dropped anything on it. Nothing I had done the days prior explained the pain. What does the hospital do? Send me home with a script for oxy’s. Went back two days later to find out I had an infection in my arm that deteriorates the soft tissue. On another visit I had a sharp pain in my right side for a few days. My wife and I both thought it was my appendix. Go to the ER and even the Dr. did at first. Ran a very few test and did 3 x-rays and luckily it was not my appendix. I had swollen limp-nods in my lower right abdomen causing the pain. Instead of even trying to figure out what caused the swollen limp-nods, guess what they did? That’s right, another script for oxy’s. They give out like candy anytime someone comes in there claiming to be in pain. They do not fix or try to resolve the issue that caused the pain. They just mask it with pain meds.

    • You’re upset that they treated your pain? Honestly, your story sounds like fake news! Doctors are so stingy with pain meds now

    • I don’t know where you live, but that sounds ludicrous. Not that they didn’t find out what’s wrong, that’s rare in the ER.
      But “handing out oxy’s like candy”.
      When was this?
      Where was this?
      Even if they did give you oxy’s, it wasn’t BECAUSE they couldn’t dx you, it was IN SPITE of it.
      Americans are so dumb, it’s embarrassing.
      1) less than 1% of people prescribed a pain med WHO AREN’T ALREADY ADDICTED TO SOMETHING will become addicted to opioids.
      2) I can’t teach you & undo all your false beliefs will no source. But “opioids” used by the media includes illegal & legal opioids. Of course people die from heroin.
      But no one dies from opioids while in proper pain management.
      Pain meds have less dangerous & less overall side effects than most medications overall. They’re SAFER and they SAVE LIVES.
      Research my friend. When taken as prescribed by a reliable pain management Dr., pain meds have a very high safety profile and SAVE LIVES.
      Focus on the illicit drugs. Oh, you can’t the media has combined them under the umbrella term “opioids”.
      FYI, you never know what is in illicit fentanyl. Methamphetamine, etc ANYTHING.

  • Dale, I have 3 illnesses that cause pain. Serious pain. I could name you a list of names of people who seek opioids for recreational purposes. I never take more than my recommended dosage with the appropriate time between doses. I also don’t take a sleeping pill if I have had an opiod that afternoon. But if you look at how many people for years sat hump-backed over a sewing machine, pushed a cutting machine for 8 hours a day, or pushed lumber through a planer for 8 – 10 hours a day, it makes sense that these people are probably in a lot of pain now, if they are still alive. If you are just hearing about the abuse and the over-abundance of mis-use of opiods in this region you have had your head in the sand. This has been going on for years. In fact, the major drug stores at one time were allotted a certain # of pain pills per month and if you didn’t get yours before they ran out…you were just out of luck and in excruciating pain. I do not get a high from my pain pills, they just make the pain bearable. So before you get so upset about a problem that hasn’t touched your world yet, you might want to research your subject a little more next time.

    • l lived and worked in Martinsville during one of it’s heydays 72′-85′. My job allowed me to get inside on the floor of every single factory unimpeded. It was all mostly manual labor at it’s finest. Now with still about 25% unemployment their are only I believe about two pharmacy locations serving all the county and city. Besides Walmart, there is only one location of a low-end grocer. The once bustling downtown is virtually completely boarded up. I would want something to kill the pain too! It used to be liquor at the private men’s clubs and country clubs for the well off, and back door nip joints and ABC stores for everyone else (day drinking by workers was the norm). So not much has really changed, except the product is now covered by virtually free medical insurance.

    • That’s a definite part of the picture my friend.
      Unfortunately, it goes much, much deeper on the US agenda.

    • Susie Q That may be the worst part. That REAL pain patients NEVER abuse pain meds.
      But while the media plays word games they excel at so well, the truth is 100-150 MILLION chronic pain patients will be left with suicide, illegal drugs, or dying FROM pain as their choices.
      My experience in 2014 was I went to 10 (TEN) pharmacies who said they were out of my meds! I finally found a smaller one that would give a pt 10 pills & tell them to come back when they got their shipment for the remaining pills. They gave everyone some instead of a few the whole thing at one time. Large chains said this was illegal.
      Today, I doubt they are allowed to do that, although what the reasoning behind it is I don’t know?
      If pharmacies were short in 2014 due to DEA restrictions, then what are they talking about?
      There are many nasty, illegal, and corrupt things going on in this Country right now.
      The main conclusion is they want to get rid of these old people in pain. Early. Keeping them alive drains the system (THEY paid into) Medicaid, disability, etc etc. More importantly, they made a promise to fulfill with the UN & G8 Countries in 1993 regarding sustainability. As in, the World can’t sustain the growing population, so they must REDUCE POPULATION.
      It’s in plain sight, depopulation. But how? Getting CPP’s and addicts to kill themselves seems a good start.
      I have researched & have all the info, mostly out of the mouths of politicians, etc to back this incredulous theory up, I could write a book. But who would read it? A brainwashed Country with no empathy? Unlikely.
      It’s all out in the open, no one reads it. Agenda 21 Wikipedia plainly states reducing the population of the G8 Countries as a goal. Check the sources on Wiki. Read the real document.
      I kept thinking, the more research I did, it’s like they’re trying to kill us.
      The DSM-5 redefines addiction as dependence. The Dr leading it works for a PHARMA CO creating a new drug for ALL kinds of addiction. Now Drs will diagnose dependence as addiction & INSURANCE co will PAY for her new drug.
      1 piece of the puzzle. Dependence is very different from addiction. Now a dying cancer pt is EXACTLY the same as the recreational drug user, except the cancer pt suffers & suffers from their “addiction” & the addict either finds illicit drugs (heroin Afghanistan/win for the gov, with history & current events requires it’s own book, but you can see US soldiers guarding poppy fields on YT & Afghani farmers & US saying WHY) or gets on this Drs expensive new drug for addiction (not out yet) which politicians, Drs, insurance co’s, FDA, etc etc will benefit from in the BILLIONS, it will be the new Purdue’s oxycontin to the medical field, FDA, politicians, & gov once it sets up some “addiction centers”.
      They have to convince the public first, hence the media war on addiction, combining prescriptions & illicit drugs under the umbrella term “opioids”, & CPP’s not being represented by the CDC, much less in Washington or the media.

  • I LIVE in Martinsville and find this information MOST upsetting ! I am sure there are RECORDS of Who is prescribing these, AND who is BUYING THEM . I Demand that Something be done.

    • Look for the sickest and oldest people you can find, preferably those with cancer. Assuming you’re a good Christian woman, what can be done is bringing them dinner or sending the young ones to help with chores, groceries etc…

    • You DEMAND? Instead of demanding, get involved. Call Piedmont Community Services at 276.632.7128 and ask to speak to someone about Drug Free MHC, then inquire about the Opioid/Heroin Overdose Reduction Task Force. It’s all hands on deck time and concerned citizens are welcome to join.

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