South Dakota’s Painkiller Prescription Rates Continue to Rise

By Paul Gaita 06/21/16

Along with a significant increase in opioid prescriptions, the state has also experienced a rise in drug arrests.  

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South Dakota’s Painkiller Prescription Rates Continue to Rise

Despite guidelines issued by the Centers for Disease Control and Prevention (CDC) and other health groups to reduce the number of opioid pain medication prescriptions written each year, law enforcement officials in South Dakota reported a 22% increase in painkiller prescriptions last year, which may coincide with an increase in violent crime reported for the same time period.

A state report showed that South Dakota doctors had already written more than 280,000 opioid prescriptions between January and May of this year. While law enforcement officials predicted that the number may drop slightly in the second half of 2016, the amount reflects an increase in opioid prescriptions over the last three years. 

In 2015, doctors wrote 710,000 opioid prescriptions for South Dakota residents—a sizable increase from the 583,428 written in 2014, and more than twice the increase between 2013 and 2014. The numbers also stand in sharp contrast to the state’s national ranking in a 2012 report from the CDC, which showed South Dakota giving out fewer prescriptions per 100 people than most of the other Great Plains states, including Iowa, Nebraska and Montana.

"[The increase] is huge, especially for a little state like ours,” said Kari Shanard-Koenders, executive director of the South Dakota Board of Pharmacy. “That’s almost enough for a prescription for every man, woman and child in the state.” Recent census numbers place the state population of South Dakota at 843,110.

As a result, drug arrests have also increased across the state. A report from the South Dakota Attorney General’s office noted that law enforcement officials made more than 6,000 drug arrests in 2015, which is 1,000 more than the number made the previous year. While some arrests have been attributed to an increase in meth sales and use in the southern part of the state, Minnehaha County Sheriff Mike Milstead noted that opioid and heroin use are also contributing factors. “The opioid and heroin problems are real and very troubling,” he told the Argus Leader. “I ordered Narcan two weeks ago for my deputy officers so they can save people overdosing on heroin or opioids. I didn’t think I’d ever see this day in my career, but it’s here.”

Milstead also said that the increase in opioids and heroin, as well as fentanyl, have led to more violent confrontations between buyers, dealers, the police and even bystanders. “These are the people in our community that don't seem afraid to pull the trigger,” he stated.

Doctors in the state are trying to stem the tide of prescriptions to meet national guidelines through a variety of methods, but report that progress has been challenged by a number of factors. Dr. Craig Uthe, physician director of clinic services at Sanford Health, says that doctors in the health care system have been working to find opioid alternatives for patients and using care teams to help individuals with long-term opioid addictions, but finds that many patients have come to expect painkillers as part of chronic pain treatment.

“It’s really difficult to say no to your patient who’s in chronic pain,” he said. “But we'd rather give the patient what he needs, even if it isn't always what he wants.”

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Paul Gaita lives in Los Angeles. He has contributed to the Los Angeles Times, Variety, LA Weekly, Amazon.com and The Los Angeles Beat, among many other publications and websites.