PRESCRIPTION OPIOIDS FOR CHRONIC PAIN


Oxycodone Treatment

Chronic pain, which is defined as pain that lasts longer than 3 to 6 months, is extremely common, persistent and often difficult to treat. The Institute of Medicine (IOM) estimated that 100 million American adults, which is one-third of the adult population, suffer from chronic pain. Over the past 10 years, there has been a significant increase in the prescription of opioid medications for chronic pain, despite the limited evidence indicating its long-term beneficial effects.

Accumulating evidence also indicates increasing rates of problems associated with prescription painkillers, including accidental overdose, abuse, addiction, diversion, and accidents involving injuries such as falls and motor vehicle accidents. In 2010, there were 16,651 fatal overdoses involving prescription opioids and over 400,000 emergency department visits.


 

ADDICTION TO PRESCRIBED PAINKILLERS

While the use of opioids for pain treatment continues to be a subject of considerable debate, it is now understood that it poses a serious problem for the nation, as abuse of painkillers has dramatically risen. In 2011, the Centers for Disease Control and Prevention (CDC) reported that more Americans died from prescription painkiller overdoses than deaths from both cocaine and heroin combined.

Prescription Painkiller Related Trends
Oxycodone Treatment

The most commonly abused prescription drugs are:

  • Opioids, such as oxycodone (Oxycontin) and those containing hydrocodone (Vicodin), used to treat pain

  • Anti-anxiety medications and sedatives, such as alprazolam (Xanax) and diazepam (Valium), and hypnotics, such as zolpidem (Ambien), used to treat anxiety and sleep disorders

  • Stimulants, such as methylphenidate (Ritalin), used to treat ADHD and certain sleep disorders
Many individuals who misuse prescription drugs, particularly teens and young adults, believe these substances are safer than illicit drugs because they are prescribed by a healthcare professional and dispensed by a pharmacist. However, taking them for nonmedical use to “self-medicate” or to achieve euphoria can be just as dangerous and addictive as taking any other illegal drug.

Recent studies have shown that a young person is more likely to abuse a prescription drug than any other illegal street drug, as they have become more readily available, whether from their home, friends or physician. Put into perspective, according to the CDC, there are enough prescription painkillers prescribed a year to medicate every American adult around-the-clock for an entire month.

Most prescription painkillers are prescribed by primary care and internal medicine doctors and dentists, not specialists. It is important to note that roughly 20% of said doctors prescribe 80% of all prescription painkillers in the nation.

Through a better understanding of the groups at highest risk for overdose, government and health organizations, better successful interventions can be developed. The groups who are most vulnerable to prescription drug overdose include:

  • Individuals who obtain multiple controlled substance prescriptions from multiple providers—a practice known as “doctor shopping”.

  • Individuals who take high daily dosages of prescription painkillers and those who misuse multiple abuse-prone prescription drugs.

  • People with mental illness and those with a history of substance abuse.

People on Medicaid are prescribed painkillers at twice the rate of non-Medicaid patients and are at six times the risk of prescription painkillers overdose. One Washington State study found that 45% of people who died from prescription painkiller overdoses were Medicaid enrollees.

WHERE DO YOUNG ADULTS OBTAIN PRESCRIPTION PAINKILLERS?

The Office of National Drug Control Policy (ONDCP) findings from the Substance Abuse and Mental Health Service Administration’s (SAMHSA) National Survey on Drug Use and Health (NSDUH) for 2009 and 2010 show that 55% of persons who used painkillers non-medically obtained the drugs from a friend or relative for free, another 11% bought them from a friend or relative, and 5% got them from a friend or relative without asking. This adds up to 71% of individuals who obtained their most recently used painkillers from their friends and family.

In addition, it is important to note that the more frequent prescription painkillers are used, the more likely they were obtained from doctors or purchased, rather than by getting them for free. Some key findings from this analysis include:

  • Among new abusers of pain relievers, 68% of new users (those who began misuse of pain relievers in the past year) obtained their abused pills from a friend or relative for free or took them without asking, 17% were prescribed by one or more doctors, and 9% were purchased from a friend, dealer, or the Internet.

  • Among occasional abusers of pain relievers (less than once a week on average in the past year), 66% obtained the pills for free from a friend or relative or took them without asking, 17% were prescribed from one or more doctors, and 13% were purchased from a friend or relative, dealer, or the Internet.

  • Among chronic abusers of pain relievers only 41% obtained the pills for free or without asking from a friend or relative, 26% were prescribed from one or more doctors, and 28% were purchased from a friend or relative, dealer or the Internet.