WASILLA -- Soaring heroin overdose death rates in Alaska still don't outpace the rate of fatal overdoses from prescription opioid pain relievers, according to the Alaska Department of Health and Social Services.
Deaths from heroin increased from seven in 2009 to 36 deaths last year, according to a bulletin released Thursday by the state Division of Public Health.
The number of fatal overdoses from prescription opioids was far higher: 83 deaths last year, down from 104 deaths in 2009.
Fatal overdoses linked to prescription pain medications dropped considerably in 2010 after pharmaceutical companies changed formulations to deter abuse but then began rising again, according to Dr. Jay Butler, the state's chief medical officer and director of the public health division.
Public health officials say Alaska is in the midst of a heroin epidemic the state is ill-prepared to handle, given a lack of detox and treatment options here. A bill moving through the Legislature would remove barriers to the use of naloxone, medication that can reverse the respiratory depression that causes overdose deaths.
There's generally less talk about the dangers of prescription pain medications, except as a stepping stone to heroin for some users.
Asked if public awareness of prescription opioid overdose risk is getting lost in the current focus on heroin, Butler said, "it's not an either/or."
Of the roughly three-dozen heroin deaths last year, 19 of the people also had prescription opioids in their systems, he said. "That tells us it's more than people moving from prescription opioids to heroin."
People may supplement with pain medications "between hits of heroin" or use heroin to increase the effects of pills, Butler said.
State public health officials say the findings point to the need to adopt new chronic pain management guidelines and increasing naloxone availability.
The bulletin addressed drug overdose deaths in general, a category that also includes deaths from substances such as cocaine or stimulants. Total overdose deaths in Alaska dropped from 131 in 2009 to 121 last year.
Overdose death rates remained highest among males and middle-aged adults, according to the bulletin. The regional distribution of drug overdose deaths was considerably higher in regions with urban centers and growing populations, although all regions were affected.
Alaska Dispatch Publishing