While the breakneck upswing in opioid abuse has leveled off, it remains disturbingly high and does not appear to continue its decline, according to an analysis of national data presented at the ANESTHESIOLOGY® 2017 annual meeting.
More than 13 percent of Americans 12 and older – nearly 1 in 7 – have abused prescription opioids at some point in their lives, researchers determined after analyzing the latest data from the National Survey on Drug Use and Health (NSDUH), an annual survey sponsored by the Substance Abuse and Mental Health Services Administration. Additionally, while 8.6 percent of Americans abused opioids in 2000, by 2003 that number jumped to 13.2 percent, and it has remained steady at that level.
“The amount of opioid prescriptions being written in the United States is breathtaking – essentially enough for every American adult to have a bottle of the pain killers in their medicine cabinet,” said Asokumar Buvanendran, M.D., lead author of the study, director of orthopedic anesthesia and vice chair for research at Rush Medical College, Chicago, and chair of the American Society of Anesthesiologists (ASA) Committee on Pain Medicine. “This in turn leads to opioid abuse because people may take more than needed, or the pills fall into the wrong hands. That’s got to change.”
Because opioids can produce euphoria, they are highly likely to be abused. Opioid prescriptions are often written for an excessive number of pills, so patients may take more medication than they need and become addicted.
Additionally, medication that is unused can be diverted to another person for illicit use. More than half of the people who misuse prescribed opioids get them from a friend or relative, not a physician, according to NSDUH data.
The NSDUH survey asked Americans if they had taken prescription opioids without a prescription written for them (which constitutes abuse) anytime in their lives. The researchers determined that in 2014 (the last year for which data is available), 13.6 percent of Americans had abused prescription opioids. Use of hydrocodone (including Vicodin, a combination of hydrocodone and acetaminophen) increased from 3.2 percent in 2000 to 9.1 percent in 2014. Use of oxycontin increased from less than 1 percent in 2000 to 3 percent in 2014.
Hydrocodone is the most frequently prescribed and therefore the most frequently abused opioid, researchers noted.
“While the illicit opioid use trend seems to have plateaued, there’s no evidence of a decline yet,” said Mario Moric, M.S., co-author of the study and a biostatistician at Rush Medical College. “Hopefully with increased national attention to the problem we will see a significant drop in abuse.”
“Opioids are still an important tool for dealing with pain, but doctors need to prescribe fewer quantities,” said Dr. Buvanendran. “Also, patients need to be educated about the dangers for overuse and abuse and understand that pain usually can’t be solved solely with a pill, but needs to include exercise, physical therapy, eating right, having a social support system and developing good coping skills.”
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