Just recently I posted an article about a study linking overuse of prescription painkillers to recovery complications from knee replacement surgery. Now comes more sobering news from the Centers for Disease Control and Prevention (CDC) about prescription painkillers.
The death toll from overdoses of prescription painkillers has more than tripled in the past decade, according to an analysis in the CDC Vital Signs report recently released from the CDC. This new finding shows that more than 40 people die every day from overdoses involving narcotic pain relievers like hydrocodone (Vicodin), methadone, oxycodone (OxyContin), and oxymorphone (Opana).
“Overdoses involving prescription painkillers are at epidemic levels and now kill more Americans than heroin and cocaine combined, ” said CDC Director Thomas Frieden, M.D., M.P.H. “States, health insurers, health care providers and individuals have critical roles to play in the national effort to stop this epidemic of overdoses while we protect patients who need prescriptions to control pain. ”
The increased use of prescription painkillers for nonmedical reasons (without a prescription for the high they cause), along with growing sales, has contributed to the large number of overdoses and deaths. In 2010, 1 in every 20 people in the United States age 12 and older—a total of 12 million people—reported using prescription painkillers nonmedically according to the National Survey on Drug Use and Health. Based on the data from the Drug Enforcement Administration, sales of these drugs to pharmacies and health care providers have increased by more than 300 percent since 1999.
“Prescription drug abuse is a silent epidemic that is stealing thousands of lives and tearing apart communities and families across America, ” said Gil Kerlikowske, Director of National Drug Control Policy. “From day one, we have been laser–focused on this crisis by taking a comprehensive public health and public safety approach. All of us have a role to play. Health care providers and patients should be educated on the risks of prescription painkillers. And parents and grandparents can take time today to properly dispose of any unneeded or expired medications from the home and to talk to their kids about the misuse and abuse of prescription drugs. ”
In April, the Administration released a comprehensive action plan to address the national prescription drug abuse epidemic to reduce this public health burden.
Titled “Epidemic: Responding to America’s Prescription Drug Abuse Crisis , ” the plan includes support for the expansion of state–based prescription drug monitoring programs, more convenient and environmentally responsible disposal methods to remove unused medications from the home, education for patients and healthcare providers, and support for law enforcement efforts that reduce the prevalence of "pill mills" and doctor shopping.
Already, 48 states have implemented state–based monitoring programs designed to reduce diversion and doctor shopping while protecting patient privacy and the Department of Justice has conducted a series of takedowns of rogue pain clinics operating as “pill mills. ” President Obama has also signed into law the Secure and Responsible Drug Disposal Act, which will allow states and local communities to collect and safely dispose of unwanted prescription drugs and support DEA’s ongoing national efforts to collect unneeded or expired prescription drugs which have collected over 300 tons of medications over the past year.
“Almost 5,500 people start to misuse prescription painkillers every day, ” said Substance Abuse and Mental Health Services Administration Administrator Pamela S. Hyde. “Just like other public health epidemics, community–based prevention can be a proven, life–saving and cost–effective key to breaking the trend and restoring health and well–being. ”
The prescription painkiller death rates among non–Hispanic whites and American Indians/Alaska Natives were three times those of blacks and Hispanic whites. In addition, the death rate was highest among persons aged 35–54 years. Overdose resulted in 830,652 years of potential life lost before age 65 years, a number comparable to the years of potential life lost from motor vehicle crashes and much higher than the years of potential life lost due to homicide.
For the analysis, CDC reviewed state data on fatal drug overdoses, nonmedical use of prescription painkillers, and sales of prescription painkillers to pharmacies and health care providers.
The study found:
- State death rates from overdoses (from 2008 data) ranged from a high of 27.0 deaths per 100,000 people in New Mexico to a low of 5.5 deaths per 100,000 people in Nebraska.
- Nonmedical use of prescription painkillers ranged from a high of 1 in 12 people aged 12 and older in Oklahoma to a low of 1 in 30 in Nebraska. States with more nonmedical use tend to have more deaths from drug overdoses.
- Prescription painkiller sales per person were more than three times higher in the highest state, Florida, than in the lowest state, Illinois. States with higher sales per person tend to have higher death rates from drug overdose.
While national strategies are being strengthened, states, as regulators of health care practice and large public insurers, can take the following steps to help prevent overdoses from prescription painkillers and reduce this public health burden:
- Start or improve prescription drug monitoring programs, which are electronic databases that track all prescriptions for painkillers in the state.
- Use prescription drug monitoring programs, public insurance programs, and workers’ compensation data to identify improper prescribing of painkillers.
- Set up programs for public insurance programs, workers’ compensation programs, and state–run health plans that identify and address improper patient use of painkillers.
- Pass, enforce and evaluate pill mill, doctor shopping and other state laws to reduce prescription painkiller abuse.
- Encourage professional state licensing boards to take action against inappropriate prescribing.
- Increase access to substance abuse treatment.
CDC is also releasing “Policy Impact: Prescription Painkiller Overdoses, ”one in a series of issue briefs highlighting key public health issues and important, science–based policy actions that can be taken to address them. Through this new publication, CDC supports state–based efforts to reduce prescription drug abuse while ensuring patients have access to safe, effective pain treatment.
For more information about prescription drug overdoses in the United States, please visitwww.cdc.gov/HomeandRecreationalSafety/Poisoning.