The stats on prescription painkiller abuse in the US are staggering. According to the Centers for Disease Control & Prevention (CDC), each day, 46 people die from an overdose of prescription painkillers just in the US. Meanwhile, unintentional overdose deaths involving opioid pain relievers have quadrupled since 1999, outnumbering those involving heroin and cocaine by 2007. (3) Despite all the warnings and tales of misuse, healthcare providers still wrote 259 million prescriptions for painkillers in 2012, enough for every American adult to have a bottle of pills.(1)
A Growing Problem
The nonmedical use and abuse of prescription painkillers — opioid or narcotic pain relievers, including Vicodin, OxyContin (oxycodone), Opana and methadone — is a serious public health problem in this country. Although most people take prescription medications responsibly, an estimated 52 million people (20 percent of those aged 12 and older) have used prescription drugs for nonmedical reasons at least once in their lifetime. (3)
The number of prescriptions for some of these medications has increased dramatically since the early 1990s. Moreover, a consumer culture where we think every ailment requires a cure in pill form as well as the perception of prescription drugs as less harmful than illicit drugs are other likely contributors to the problem.
A Recipe for Addiction?
The abuse of certain prescription drugs can lead to a variety of adverse health effects, including addiction. Among those who reported past-year nonmedical use of a prescription drug, nearly 14 percent met the criteria for abuse of or dependence on it. (3) The reasons for the high prevalence of prescription drug abuse vary by age, gender, and other factors, but likely include greater availability.
Not all areas of the US stack up the same when it comes to prescription use and abuse. It turns out that 10 of highest prescribing states for painkillers are in the South. This is notable because health issues that cause people pain don’t vary much by geographic location, certainly not enough to explain why, in 2012, healthcare providers in the highest-prescribing state wrote almost three times as many opioid painkiller prescriptions per person as those in the lowest prescribing state in the US.
Data suggests that where a healthcare provider practices does influence how they prescribe, and an increase in painkiller prescribing is a key driver of the increase in prescription overdoses. Nearly 22 times as many prescriptions were written for oxymorphone in Tennessee as were written in Minnesota. The Northeast, especially Maine and New Hampshire, had the most prescriptions per person for long-acting and high-dose painkillers. Additionally, many states report problems with for-profit, high-volume pain clinics (pejoratively nicknamed “pill mills”) that prescribe large quantities of painkillers to people who don’t have a legitimate medical need.
The Doctor’s Role
One way to curb the large and growing problem of prescription drug abuse in the US would be requiring doctors to use databases to record and track patients’ prescriptions, ending the problem of “doctor shopping.” This would allow a doctor about to write a prescription for the painkiller OxyContin to look up the patient in the database to see whether the drug had recently been prescribed by another doctor. (2)
But there is opposition – including from the American Medical Association. The AMA recently announced its opposition to any federal legislation requiring physicians to check a prescription drug-monitoring program. Their criticisms include that it’s an inefficient system, it’s time-consuming and it takes the providers away from direct patient care. Many experts also contend that doctors shouldn’t bear the sole responsibility for fighting the nation’s prescription drug problem. (2)
37 states have prescription drug monitoring programs, but most do not require doctors to use them. And some doctors want use of the databases to remain voluntary, saying that it is not the role of physicians to police drug use.
It can seem like an overwhelming problem, but there are things that can be done to lower those statistics. Doctors alone can’t put an end to prescription drug misuse and abuse. Efforts can and are being made to prevent overprescribing while continuing to ensure that access to safe, effective pain treatment remains available to those with a legitimate need.
There are things we can all do on an individual level as well. Everyone can avoid taking prescription painkillers more often than prescribed. It’s also important to dispose of medications properly and avoid keeping prescription painkillers or sedatives around the house. And never share prescription drugs with others or take medication prescribed to someone else.
If you or a loved one is struggling with substance abuse, call us today. We’re available 24 hours a day, seven days a week and can provide information on treatment programs, help with insurance and answer questions about the treatment process.
(1) Centers for Disease Control & Prevention – Opioid Painkiller Prescribing, http://www.cdc.gov/vitalsigns/opioid-prescribing/, accessed August 13, 2014
(2) Live Science – Prescription Drug Problem Sparks Debate Over Solutions, My Health News Daily, http://www.livescience.com/36486-prescription-drug-abuse-solutions.html, accessed August 11, 2013
(3) NIDA – Prescription Drug Abuse: From the Director, http://www.drugabuse.gov/publications/research-reports/prescription-drugs/director, accessed August 12, 2014