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Like most states in the U.S., Texas is facing a severe problem with abuse of and addiction to prescription opioids , such as hydrocodone (Vicodin) , oxycodone (OxyContin, Percocet), morphine (Kadian, Avinza), codeine and related drugs. Opioid medications are typically prescribed for painful conditions, including dental work and injury-related pain. Morphine is often used before and after surgical procedures to alleviate severe pain. Prescriptions for codeine are more commonly used for mild pain, but are also given to relieve symptoms like coughing and diarrhea. These drugs have legitimate medical uses, but they are also being used in unintended ways and for durations longer than necessary, and they are often diverted or sold to those who do not have legal prescriptions or genuine conditions requiring these medicines. During the “America’s Addiction to Opioids” presentation, which was given to the Senate Caucus on International Narcotics Control, Nora Volkow stated, “Several factors are likely to have contributed to the severity of the current prescription drug abuse problem. They include drastic increases in the number of prescriptions written and dispensed, greater social acceptability for using medications for different purposes and aggressive marketing by pharmaceutical companies. These factors together have helped create the broad environmental availability of prescription medications in general and opioid analgesics in particular.” According to the report “Substance Abuse Trends in Texas,” hydrocodone is the most prevalent prescription opioid used for nonmedical purposes in the state. The report also indicates an increasing problem with abuse of codeine cough syrup and attributes the rise, in part, to music promoting “sippin’ syrup” and several cases of popular singers getting in trouble because of their use of “syrup.” In 2015, Texas providers wrote 15.9 million prescriptions and there were 617 prescription opioid-related overdose deaths in the state.1 Experts say most of the people addicted to opioids in Texas are not abusing heroin. Instead, they’re taking prescription painkillers like Oxycodone and OxyContin.2 In 2017, about two-thirds of opioid-related exposure calls to the Texas Poison Center Network were made for commonly prescribed opioids, and of the 1,174 Texas deaths involving opioids in 2015, 517 involved opioid painkillers.3 Trends in Texas center around illicit pain clinics, pharmacies and physicians. The most desired pharmaceuticals continued to be the three that constitute what is known as the Houston Cocktail: hydrocodone, carisoprodol (Soma), and alprazolam (Xanax) . The DEA reported prescriptions from Houston pain management clinics were filled in pharmacies as far north as Oklahoma, as far east as Alabama and as far west as El Paso. Large numbers of patients from Louisiana and other states travel to the Houston area for the purpose of prescription fraud. Pill crews recruit “patients” to fraudulently obtain multiple prescriptions from pain clinics, which are filled at local pharmacies and then given to the pill crew leader for illicit distribution. Houston area physicians were also found to be mailing prescriptions to patients in other states—primarily Louisiana and Mississippi. Monitoring Abuse and Controlling Diversion Texas House and Senate committees continue to examine ways to limit prescription drug abuse and agree that Texas should interactively share its drug monitoring database with other states. State lawmakers also propose that doctors should be encouraged to use online databases identifying patients who “doctor shop” for medications. Since diversion of prescription drugs is a significant abuse problem, The Texas Prescription Program was created to monitor controlled substance prescriptions. This program provides an efficient, cost-effective tool for investigating and preventing drug diversion. Medical practitioners and pharmacists use the program to verify records and inquire about patients to help detect possible illicit use. In addition, the program can be used to generate and disseminate information regarding prescription trends. Naloxone Available Without A Prescription Another recent effort to combat the increase of deaths from opioid overdose involves the drug naloxone .

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