The rate of prescriptions dispensed for powerful opioid painkillers in Western New York is significantly higher -- by 70 percent -- than the state average, according to a Buffalo News analysis of prescription data the state collects.
Statewide, pharmacies in 2009 dispensed 37 prescriptions for fentanyl, oxycodone and hydrocodone for every 100 residents. In the eight counties of Western New York, the average rate was 65 per 100.
The numbers are particularly high in Niagara Falls and throughout much of Buffalo. Pockets of Chautauqua and Cattaraugus counties also have some notably high prescription opioid rates.
Some of the highest numbers are in some of the poorest areas of the state -- many of them in Buffalo and Niagara Falls, according to the News analysis.
Federal law enforcers, as well as some drug treatment administrators, speculate the presence of the two doctors who write the largest number of prescriptions for controlled substances in the state helps explain the Western New York numbers.
The No. 1 prescriber, Dr. Eugene Gosy, runs a pain management center in Amherst, with referrals from some 2,700 doctors.
The No. 2 prescriber, Dr. Pravinchandra V. Mehta, was recently arrested and accused of running his Niagara Falls medical office as if he was a drug dealer.
"I would think it is a cause and effect," said William R. Burgin, a drug treatment professional who is executive director of Alcohol and Drug Dependency Services in Buffalo. "If you have the No. 1 and No. 2 in the area, you have more prescription drugs in the community than in others."
Others cite the area's high poverty rate.
"When people are poor, they often receive pain medications and muscle relaxants for a wider range of conditions than a well-off person, who may choose to first explore treating through a wide range of holistic treatments," said Sister Noreen McCarrick, a mental health expert and social worker in Niagara Falls.
The area's elderly population and its high rates of cancer, an illness in which painkiller use is accepted and common, may also be factors.
The Buffalo News obtained prescription data from the state Health Department for hydrocodone, oxycodone and fentanyl -- all opioids classified as narcotic painkillers and all listed as controlled substances.
The data identifies each prescription dispensed for those drugs in 2009 according to the zip code where the patient lived.
Among other findings:
* Hydrocodone is prescribed in Western New York at a rate more than twice the state average, and equal to one prescription for every two residents. The drug is more associated with the poorer communities in the state. Of the 50 wealthiest zip codes analyzed, six had hydrocodone rates that exceeded the state average. Of the 50 poorest, 24 exceeded the state average.
* Niagara County is a hot spot for fentanyl, which is more prevalent in Niagara County on a per capita basis than in any county in the state except Schuyler County in the Finger Lakes.
* Oxycodone is more popular in wealthier downstate communities, particularly in the Hudson Valley and on Long Island, as well as Staten Island. Oxycodone does not stand out in any of the Western New York counties. But the highest rate of prescriptions for the drug in Western New York is in some Cattaraugus County communities and Buffalo neighborhoods.
* Prescription opioids are not as popular in New York City as in the rest of the state, with one exception -- oxycodone on Staten Island.
The lower rates of opioid prescribing in New York City may indicate a difference in the illegal drug trade, law enforcement officials speculated. In New York City, the theory goes, the market for cocaine and heroin remains strong compared with Western New York, where painkillers have grown in importance in illegal street sales.
-- By Susan Schulman, with contributions from Patrick Lakamp and Lou Michel
>The drug: Fentanyl
For chronic pain or as an anesthetic. Available as injection tablet, lozenge or time-released patch.
Street name: Lollipop
Retail Price: $30
Street price: $20 for 25mg patch