Illicit drug use and abuse is a major problem in West Virginia, and according to a new study, the state once again ranks near the top of the list — but this time in a category that at first glance doesn't seem as dangerous.
The Center for Disease Dynamics Economics & Policy showed West Virginia ranking second highest in 2010 — just behind Kentucky — for antibiotic use. In West Virginia alone, there were 1,177 prescriptions for every 1,000 people.
Antibiotics have been a lifesaver in modern medicine, but medical officials worry that too much of a good thing will lead to more problems and possibly negate the good qualities of the drugs by creating more resistant bacteria.
Joe Good, pharmacist and owner of Joe Good Pharmacy in Pinch, has seen the problem of over-prescribing in his office. Good said 10-20 percent of people coming into his pharmacy have prescriptions for antibiotics.
"At least half come in here with viral infections," Good said noting antibiotics are used for bacterial infections and do virtually nothing for viral infections. "Half the people coming in here have just the common cold, so we're looking at maybe 50 percent coming in here with prescriptions for antibiotics who don't really need them."
Dr. Rahul Gupta, executive director of the Kanawha-Charleston Health Department, said many people may not be aware that several common diseases don't warrant an antibiotic prescription.
"A bulk of diseases, especially in this season with colds, sore throats and flu are viral infections," he said. "Antibiotics treat bacteria. There is no use for these infections; yet, these medications are often prescribed."
Why is antibiotic abuse a problem?
Overuse of antibiotics can cause bacteria resistance, making certain ailments such as urinary tract infections harder to treat, Gupta explained.
Overusing antibiotics also can eliminate good bacteria in the body, such as bacteria in the stomach, Good said.
"You may end up having problems because of antibiotics such as diarrhea and fungal infection," he said.
Gupta said spending unnecessary money on these drugs also places a financial burden on society. Not only do people have to pay for medicine they may not need, but Gupta said it also makes antibiotics more expensive in the future as health officials look to find new ways to overcome antibiotic-resistant bacteria.
"It's bad for society, bad for medicine and it's bad for public health," Gupta said.
It also is important to finish the full course of antibiotics. Good said many people may stop taking the medicine as soon as they feel better. This is a bad idea.
"It makes it possible for the bad bacteria to overcome it," he said. "That's why you see women developing UTIs, and children developing oral thrush."
It's not just West Virginia and Kentucky that have higher than normal use of antibiotics. In fact, other states in the Southeast, such as Tennessee, Mississippi and Louisiana, followed closely behind.
"It's well-known that in the Southeast there is more drug-resistant bacteria," Gupta said.
Alaska, Hawaii, California and Washington had the lowest antibiotic consumption, according to the CDDEP.
"Since 1999, the percentage of antibiotic prescriptions filled nationwide has dropped by 17 percent. However, high-consumption states are lagging in this positive trend and are seeing the smallest decrease in prescriptions, resulting in a widening use gap," a news release from the CDDEP stated, noting Appalachian and Gulf Coast states take "twice as many antibiotics per capita as people living in Western states."
Gupta said this trend in geography also plays a role in other areas, such as overall general health. In fact, many Appalachian states had lagging life expectancy or decreasing life expectancy for women. Plus, many of those same areas in the Southeast also had higher instances of chronic disease.
So could West Virginia's sick population be to blame?
Gupta said the state's health does play a role but not enough to cause as big of a spike as the study shows.
"We have a sicker population with a bigger burden of chronic illnesses. We have a high miserability index, but then again, we also understand that the states that rank lower are the ones that have spent a significant amount of investment into public health and education for their physicians, residents and students in the field of medicine to understand that not every treatment demands antibiotic prescriptions."
What can be done to help West Virginia and other states' situation?
Gupta said patients should listen to their doctors or educate themselves about antibiotics.
"One simple advice is get smart," he said. "If you don't need it, don't ask for it from your provider, because if you ask for it, the likelihood that you will get it is high."
And a major responsibility is that of the providers, Gupta said.
"From a provider standpoint, it's important to educate ourselves that when there is not a need, the standard of practice applies," he said.
Good said this responsibility is just as important as patients educating themselves.