Prescription drug abuse is a huge problem in the United States, with opioid painkillers like OxyContin and Vicodin being a particular concern for public health. These painkillers have been credited with driving the soaring overdose rate in the U.S., and a new report from the CDC adds further evidence that we need to take action to bring the overdose rate down. The headline finding from this report is that opioid painkiller deaths nearly quadrupled between 1999 and 2011. Finding out more about the report and prescription drug abuse helps you understand the epidemic sweeping the country.
Understanding Prescription Drug Abuse
All you really need to understand in order to see why prescription drug abuse, addiction and overdoses are so common is that many of the substances doctors prescribe have similar effects to illicit drugs. Opioid painkillers are the best example, because if you look at how they interact with the brain, they’re effectively identical to heroin or morphine. Although they can be used safely according to a doctor’s suggested schedule, the potential for abuse is significant: taking more than your recommended dose will lead to euphoric effects and continuing to do so will quickly lead to addiction. In addition to opioid medicines, amphetamine-based medicines (like Adderall or Ritalin) and benzodiazepines (like Xanax or Klonopin) also have a role to play.
Increase in Prescription Drug-Related Deaths
The CDC’s report starts out by acknowledging that poisoning is the leading cause of injury-related death in the U.S., and that illicit and pharmaceutical drugs account for 90 percent of these deaths. The findings are based on the National Vital Statistics System’s multiple cause of death mortality files, and show that the age-adjusted rate of opioid painkiller poisoning deaths has almost quadrupled from 1999 to 2011, rising from 1.4 per 100,000 to 5.4 per 100,000. Most of these deaths were from natural and semi-synthetic opioids (including morphine, hydrocodone and oxycodone), with the numbers of deaths from these substances increasing from 2,749 in 1999 to 11,693 in 2011. Deaths from synthetic opioids (like fentanyl) also increased, but not to the same degree as those from natural or semi-synthetic varieties. In 2011, 41 percent of the 41,340 drug poisoning deaths were related to opioid painkillers, showing the sizeable contribution these substances make to the overall overdose rate.
Not all of these deaths were solely related to opioid painkillers, though, and benzodiazepines appear to be contributing more often in recent years. In 1999, only 13 percent of opioid painkiller deaths also involved benzodiazepines, compared to 31 percent in 2011.
Additionally, all age groups are not affected equally by opioid painkillers. The highest death rates are observed in those aged 25 to 34, 35 to 44 and 45 to 54, but the greatest increase in death rates between 1999 and 2011 was observed in those 55 to 64. Their death rate was 1 per 100,000 in 1999 and 6.3 per 100,000 in 2011, a more than six-fold increase.
Overdose Rates Appear to Be Decreasing
It wasn’t all bad news, though. Despite the broad increase over the time period covered, there was a difference in the speed of the increase from the start of the study to the end of the study. Between 1999 and 2006, the death rate increased by 18 percent per year, but from 2006 to 2011, the rate increased by only 3 percent each year. This could be a sign that prevention programs and other interventions are having a positive effect, but some of the difference appears to be due to the reduction in deaths related to methadone.
Although the drug is best known as a treatment for heroin abuse, it’s also used as a painkiller. However, in 2006, the FDA urged doctors to be cautious about prescribing the drug, and in 2008, manufacturers agreed to distribute the largest doses only to hospitals and addiction treatment programs. The statistics show that methadone was involved in 38 percent of all opioid painkiller deaths in 2007, but this had decreased to 26 percent in 2011. Drug awareness programs, treatment and law enforcement efforts are also believed to have played an important role, however.
Reducing Opioid Overdose Rates
The main impact of this report is as a reminder that despite our continued efforts, prescription drug overdoses are still a huge problem in the U.S. It’s also important to note that in 2011, a quarter of all drug-poisoning deaths didn’t include data about the specific drug involved, so these figures could still be an underestimate. Continuing efforts with prevention and education programs are essential to counteract the problem. In short, more and more Americans need to be aware that opioid medications are both dangerous and highly addictive.28