I'm not sure who the idiots are here, the doctors that were quoted or the reporters who quoted them...you be the judge

By Curtis Krueger and Letitia Stein, Times Staff Writers with comments from ME!
In Print: Monday, August 22, 2011


A new report released last week found Pinellas and Pasco counties leading the state in an alarming count — the number of people fatally overdosing on the most lethal prescription drugs.

That leads to two possible conclusions, both dismaying. Either the Pinellas and Pasco communities are at the epicenter of Florida's prescription drug epidemic, or drug abuse deaths only seem highest in these counties because other regions are not reporting theirs so completely. (I see one more possible conclusion that actually IS supported later on in this article, Pinellas and Pasco are OVERREPORTING the deaths.)

And if the second is true, the statewide problem is even worse than experts think. (And if these yahoos get tax dollars to "solve" their "problem", our economic situation is worse than we think.)

"Either it's real, we really are higher, or they're under-reporting elsewhere," said Dr. Jon Thogmartin, the Pinellas-Pasco medical examiner. (LMAO! Thank God this guy only works with people who are already dead.)

The report from the Florida Medical Examiners Commission found that 2,710 deaths in Florida last year were caused by prescription drug overdoses, up 8.9 percent from 2009. That's almost eight people a day.

But if other regions of the state are under-reporting, that number could be much higher. (Lower if P&P are overreporting.)

"I've always felt that the numbers that are reported in the annual report actually underestimate the problem because some cases simply don't get reported for one reason or another," said Bruce Goldberger, professor and director of toxicology at the University of Florida College of Medicine.

The calculus of drug deaths in Florida reveals a lot about the science, the detective work and the human tragedy of trying to quantify an epidemic in which legal drugs are killing far more Floridians than illegal ones such as heroin and cocaine. (Where are the heroin and cocaine numbers and are they as arbitrary as these? Irresponsibility abounds.)

In the latest report, the Pinellas-Pasco district led the state in 2010 in deaths from all six of the most lethal prescription drugs — oxycodone, alprazolam (Xanax), methadone, hydrocodone (Vicodin), morphine and diazepam (Valium). (Not one of which are used in the most lethal act we perform...capital punishment.)

The Hillsborough Medical Examiner's Office also reports some of the highest number of deaths in the state, but not as many as Pinellas-Pasco, which has a slightly higher population.

This isn't the first year Pinellas and Pasco have reported some of the highest death tolls.

As supervisor of the Pinellas Strategic Diversion Task Force, sheriff's Sgt. Dan Zsido finds it "alarming" that Pinellas is a leader. But he's not necessarily disagreeing. (Sounds like this guy sees the falacy in this article.)

"I believe that we possibly have more people that are addicted right now in this area," he said after reviewing the report. "Now, for whatever reason, we're first and we're really going to have to look at why." (Before you waste your time doing that, please check to see if this is actually a problem.)

Pinellas and Pasco have larger populations than many rural counties, which could help explain their numbers. After adjusting for population, both counties remain high — though not the highest — in per capita deaths from alprazolam, diazepam, hydrocodone and methadone. Pasco County had one of the highest rates of oxycodone deaths. (So, is this a problem or isn't it?)

Yet overall, prescription drugs still are killing more people locally than in far larger counties such as Miami-Dade and Broward. (Perhaps Miami-Dade and Broward have some sort of handle on this situation.)

Even after working to standardize procedures, Florida's medical examiners are quick to admit some things differ from district to district. And that could have an effect on which deaths get evaluated and which don't.

For starters, not everyone goes to a medical examiner's office. The doctors at these offices perform autopsies on people who die violently or from suspected drug overdoses but generally not in cases where the deaths appear to be from natural causes.

Thogmartin said Pinellas and Pasco law enforcement officers are well-trained to look for evidence of drug abuse that might not be obvious — for example, a man with heart problems who dies, but who also had a knee problem and a hydrocodone prescription. Deputies will check the number of pills in the bottle to see if the man was using them faster than prescribed, which could have led to an overdose. (How about a man with a sore knee and a prescription for hydrocodone who happens to have a heart problem? Deputies are counting the pills he DIDN'T take? How does one know he actually TOOK the rest of them? Perhaps his wife took them.)

If more cases like that get referred to the medical examiner's office, then more drug deaths are likely to be counted. (Ah...so that's it...the medical examiner needs more business.)

Thogmartin said the Pinellas-Pasco office also uses its own toxicology lab that tests extensively for drugs. That could turn up more drug deaths. It's also true that the state lacks a uniform approach to toxicology testing. (So they need MORE money to test uniformly. I'm beginning to get this.)

Even basic reporting has sometimes been spotty, medical examiners admit. Prior to this year, for example, some doctors in the Miami office were simply failing to fill out a form to indicate a prescription drug death, said Dr. Lee Hearn, director of the toxicology lab at the Miami-Dade Medical Examiner's Office.

Experts say a new statewide electronic system should correct many problems. (More money. Any doctor who forgets to fill out a form should remember to do it once they make it electronic...right?)

There is also a human factor. More than most people realize, establishing a cause of death due to drug abuse is a judgment call, medical examiners say.

"If you have five different medical examiners looking at the same case you may get two or three different opinions," Hearn said. (So what's the real problem? Prescription drugs or inept ME's?)

For any given drug, there is no precise lethal level. Some people die if their blood alcohol content reaches 0.25, but some people actually survive and even function with higher levels, said Miami-Dade Medical Examiner Bruce A. Hyma.

And different drugs are often mixed together, creating more variables to evaluate. Some autopsies are not performed until several days after death, which can make the evaluation even more difficult.

"As doctors say, there's a lot of art involved and a lot of personal preference involved," said Goldberger, a Ph.D. who runs the UF toxicology lab. "And all of this can lead to some subjective differences between districts."

Whether such differences explain why Pinellas and Pasco sit at the top of the list, Goldberger noted the evidence is clear on the most alarming finding: The trendline is up.

"Clearly too many people die every day in the state of Florida as a consequence of the use, misuse and abuse of prescription drugs," he said. (Certainly ONE death is too many, but there was nothing in this article that was written or stated "Clearly".)

How offensive is this article? These people obviously want money from our tax dollars in a time when we can least afford it. They have no real reason to get it so they are misleading us with tripe like this. You and I are being taken for morons who are dumb enough to believe what these nimrods say without any evidence. And the reporters were paid to insult our intelligence before we paid for the newspaper. No wonder the St. Pete Times is considered "the most irresponsible newspaper in the country".