Rx opiate deaths surpass heroin and cocaine combined

Nearly 15,000 people die every year of overdoses involving prescription painkillers. |||  In 2010, 1 in 20 people in the US (age 12 or older) reported using prescription painkillers for nonmedical reasons in the past year. ||| Enough prescription painkillers were prescribed in 2010 to medicate every American adult around-the-clock for a month.

From the CDC:

Deaths from prescription painkillers* have reached epidemic levels in the past decade. The number of overdose deaths is now greater than those of deaths from heroin and cocaine combined. A big part of the problem is nonmedical use of prescription painkillers—using drugs without a prescription, or using drugs just for the “high” they cause. In 2010, about 12 million Americans (age 12 or older) reported nonmedical use of prescription painkillers in the past year.

Enough prescription painkillers were prescribed in 2010 to medicate every American adult around-the-clock for a month.

Time’s Healthland blog takes issue with the the CDC’s concern about prescribing habits:

Let’s start with the facts: the vast majority of people who misuse prescription painkillers — 7 out of 10, according to drug czar Gil Kerlikowske — get them from family or friends, not directly from doctors. Secondly, most people addicted to these medications have used illegal drugs previously; they do not become addicted while being treated for pain.

A 2007 study of nearly 1,400 people addicted to OxyContin, who were treated at rehabs across the country, found that 78% had never been prescribed the drug themselves; the same percentage had been in rehab for a previous drug problem. Earlier data found that 80% of those addicted to OxyContin had previously used cocaine, a rate many times that seen in the general population.

This is a bit of a straw man. Does concern about prescribing patterns equate to saying doctors are turning pain patients into addicts?

Isn’t it of concern that friends and families have extra opiates laying around to give to friends? Doesn’t this suggest that they may have been overprescribed?

It seems like the more important data point might be the following: What percentage of misused opiates originated from a prescription?

I don’t know the answer, but it wold be helpful.

The Time post trots out more straw men:

…most people who use illegal drugs don’t subsequently go looking for dealers or rob their grandmothers to get money to buy more.

Addiction doesn’t just “happen”…they are not automatons with no free will. Their ability to choose not to take drugs may be reduced as they get hooked, but it’s not eliminated: after all, no one shoots up in front of the cops.

Even among soldiers who served in Vietnam — 45% of whom tried opium or heroin while serving — just 1% developed ongoing heroin addictions that persisted after they came home.

I agree that while adult exposure to opiates might lead to dependence, it does not create addiction. However, the CDC report uses the word addiction one time, in a sidebar, and dependence does not appear at all. It uses the words death/kill/die eleven times. The report is focused on concerns about deaths from opiates AND demonstrates a relationship between prescribing patterns, misuse and deaths. Isn’t this cause for concern?

Further, the post foreshadows a resurrection of Reagan era drug war:

The fact that addiction is not just about access to drugs is why talk of drug “epidemics” rarely changes their course. Supply-side efforts have had little effect on addiction rates. The exponential growth on such spending since Ronald Reagan declared war on drugs in the 1980s has no correlation whatsoever with rates of drug problems. The recent crackdown on prescription opioids began in the mid-2000s, with intense concern over OxyContin misuse — and yet overdose deaths continue to rise.

The post ignores that supply practices appear to have had significant influence on overdose rates over the last 10 years. Why the doubt that different supply practices might influence overdose rates? Now, I know that these things can snowball into something that bears little resemblance to what was initiated, but the CDC’s draconian governmental suggestions are:

The US government is

  • Tracking prescription drug overdose trends to better understand the epidemic.
  • Educating health care providers and the public about prescription drug abuse and overdose.
  • Developing, evaluating and promoting programs and policies shown to prevent and treat prescription drug abuse and overdose, while making sure patients have access to safe, effective pain treatment.

States can

  • Start or improve prescription drug monitoring programs (PDMPs), which are electronic databases that track all prescriptions for painkillers in the state.
  • Use PDMP, Medicaid, and workers’ compensation data to identify improper prescribing of painkillers.
  • Set up programs for Medicaid, 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 laws to reduce prescription painkiller abuse.
  • Encourage professional licensing boards to take action against inappropriate prescribing.
  • Increase access to substance abuse treatment.
Finally, after all of the concern about the CDC’s focus on supply, the author offers suggestions that include harm reduction and trying “to figure out why so many people feel the need to escape”. The words treatment and rehab appear nowhere in the discussion of alternatives to a supply side efforts.

11 Comments

Filed under Policy

11 responses to “Rx opiate deaths surpass heroin and cocaine combined

  1. Joanne Morace

    Would like to have the references for this post. Interested in reading further. Thank you.

  2. Hi Joanne,

    The reference is the CDC report linked above.

    Best,

    Jason

  3. Debbie Eisert

    Thanks, how many young people have to die? How many addicts have insurance? We have to see support for the treatment centers and easier access to them and longer stays, and then the addicts helping other addicts will start to turn the tide! AA & NA people are balanced, happy. law abiding, and powerful people!

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  5. denzidrine

    Enough prescription painkillers were prescribed in 2010 to medicate every American adult around-the-clock for a month. What is the point here? It is a whole years worth, compared to 30 days. And what is meant by medicate? Is everyone in pain? If not, then a microscopic amount would be needed.
    I’ve got severe pain that is treated inadequately because of overblown hyperbole about these drugs. The DEA is worried about the 15,000 people but An estimated 400,000 die from tobacco and 100,000 from alcohol yet, any 7-11. But alcohol and tobacco are ingrained in the culture so it’s okay. Just like Howard Stern gets fined for saying the same thing Oprah does, but Oprah is beloved, So no fine. Watch YT video – Rep. Steve Cohen (D.TN) Grills Michele Leonhart – Who is the head of the DEA.

  6. So you assume bad faith without any evidence? Maybe they base this statement on microscopic amounts? It wouldn’t be the first time the feds have been guilty of hype, but you need to support your suggestion that they are fudging. A quick google search found that there were 219 million prescriptions in retail pharmacies. I’m not clear on what pharmacies that excludes. Hospitals, other institutions and what else?

    It’s too bad we waited decades to do something about tobacco mortality. I don’t find that a compelling argument that we shouldn’t do something about a tripling in OD deaths in a 10 year period.

    • Jeff Payne

      I am in recovery. I got addicted to pain pills after a terrible accident. I now take methadone to control my pain and manage addiction. The cdc thinks people in pain can tough it out, and addicts can miraculously get better. This is not the reality. It is wishful thinking.

  7. Jeff Payne

    A lot of assumptions have been made, but I will focuse on this first incorrect statement: since 70 percent of people addicted to painkillers have also used illegal drugs, then most people addicted to opiates have did not obtain them legaly. Really? Well, lets look it up and see, shall we? I see over 90 percent of Americans have been prescribed painkillers of the narcotic variety at some point in their life. Who is writing this crap?

  8. Word to your mom

    This is how it breaks down in my eyes because I’m guilty of this and I know others that do the same. I am a military vet with spinal cord injuries. I have a prescription for Norco. I’ve been homeless and poor for some time. People know I have a prescription and ask me to sell them. I didn’t want to at first, but I need the money. So I started selling them. I’ve been addicted to them for a few years now and am finally getting clean. It’s very difficult and extremely painful to recover. Everyone I sell to obviously doesn’t have a prescription… But… They did at one time. Because they had the dependency, they want more. F*** all this talk about addicts using earlier in life. It has nothing to do with that! It has to do with having a prescription at one time and then being cut off. Just remember… All great lies are based in some truth. Peace out