Wyoming spared the worst of opioid crisis, but abuse persistent

 CHEYENNE – Wyoming hasn’t seen the type of opioid addiction that has plagued other states across the country. But even with lower levels compared to states like West Virginia and Ohio, the Equality State hasn’t escaped the crisis unscathed.

The state saw a drastic increase in the number of residents who died of opioid-related causes in 2003, which mirrored what was happening on the national level. The number of deaths in Wyoming due to illicit and prescription opioids went from a rate of 1.4 per 100,000 residents between 2003 and 2005 to 6.4 per 100,000 between 2008 and 2010.

According to a lawsuit filed by the state of Wyoming in 2018 against Purdue Pharma, the maker of OxyContin – one of the most prescribed opioid-based medications – the state paid $2.29 million in additional Medicaid claims to treat opioid-related addiction from 2008 to 2017.

From 2008 to about 2014, Wyoming’s death rate remained in line with the national average. But starting around 2014, Wyoming began to make headway in reducing the number of its residents who were dying from opioid use.

Data from 2018 produced by the University of Wyoming’s Survey and Analysis Center suggested that opioid abuse, both prescription and illicit, had started to decline as related poisoning death rates stabilize. Between 2014 and 2016, Wyoming averaged 42 overdose deaths from opioids, with an average of 7.3 deaths per 100,000 people. And those numbers have stabilized, with no sharp increase in the number of opioid-related deaths.

Compared to Ohio, which in 2017 had 46.3 deaths per 10,000 residents, and West Virginia, which had 57.8, Wyoming seems to have avoided the drastic damage some other parts of the country still face.

Lauren Gilbert, an assistant research scientist with WYSAC, said multiple factors have played into Wyoming avoiding the high addiction levels, and subsequent death rates, related to opioid abuse.

One major reason Wyoming never saw the drastic spike, Gilbert said, was it had the Prescription Drug Monitoring Program in place, which was enacted by the Wyoming Legislature in 2003. This program, which established the Wyoming Online Prescription Database, is an avenue for pharmacists to track prescriptions and make sure patients haven’t been seeing multiple doctors to obtain duplicate prescriptions for opioids.

“We were ahead of it (with this program) when opioids hit,” Gilbert said.

In a 2018 interview, Mary Walker, executive director of the Wyoming State Board of Pharmacy, said doctor shopping had plummeted 75 percent in Wyoming since 2009.

“If the patients happen to go from doctor to doctor, providers have that information at their fingertips to help with the decision to prescribe or not.” Walker said.

The program has been instrumental in locating doctors who operate what Walker calls “pill mills,” referring to unscrupulous practitioners who make money by overprescribing opioids. In places like Pennsylvania and West Virginia, pill mills were a major contributor to serious epidemics.

Along with a stronger prescription drug tracking system in place before the crisis started, Gilbert said Wyoming hasn’t see the large influx of heroin and fentanyl that major cities like Denver have experienced since the opioid crisis started.

Another reason Wyoming has seen its death rates stabilize is the expansion in availability of naloxone, also known by the commercial name Narcan. The anti-overdose medication is now available in Wyoming without a prescription, and every level of EMS certification can administer the drug, Gilbert said.

“We consider that to be a huge win for the state and dealing with the number of people overdosing,” Gilbert said. “You can go to a pharmacist without a prescription, and they’ll write a prescription for you to have it. And that opens up a lot of access to people, which has helped decrease the number of people dying.”

Wyoming also has benefited from federal grants to help with treatment and prevention programs, which Gilbert said also contributed to the static number of addictions and overdose deaths.

While the problem persists in the state, the fact that the number of people abusing opioids and opioid-related deaths has stabilized should be considered a win, Gilbert said.

“Keeping those numbers where they are is no easy thing. When it comes to addiction, there is no simple fix. There’s no magic pill to solve it completely,” Gilbert said. “It’s going to take time.”