05 Jan Prescription Pain Medication Overdoses Increasing at Alarming Rate
It used to be that when people talked about drug abuse and addiction, they were typically referring to street drugs like cocaine, heroin, or methamphetamines. However, in recent years there has been a growing epidemic of prescription drug abuse and addiction. According to a recent report by the Centers for Disease Control and Prevention (CDC), deaths caused by an overdose of prescription pain medication now exceed those from cocaine and heroin combined in the U.S.
The CDC reported that 12 million Americans aged 12 and over admitted, in a survey, to using these powerful medications for nonmedical reasons. This comes out to be 1 out of every 20 individuals in that age group. Also, per Drug Enforcement Agency data, the number of these medications sold to health care professionals and pharmacies is 300 times higher than it was in 1999. It’s no wonder this problem has escalated significantly in recent years.
The November 2011 CDC report goes on to reveal the following additional facts:
- Over the past 10 years, the death rate due to prescription painkiller overdoses has more than tripled. In fact, it’s almost quadrupled: In 1999 the death toll in the U.S. was approximately 4,000, compared to an alarming 15,000 deaths in 2008.
- The number of visits to hospital ERs associated with abuse of the powerful painkiller hydrocodone has also increased at an astounding rate. In the year 2000 this number was just over 19,000, compared to over 86,000 in 2009 (per DEA data). (Hydrocodone is sold under many different brand names including Vicodin and Lorcet.)
- Over 900 individuals died from hydrocodone in Florida from 2003 to 2007. During that same 5 year period, just over 1800 deaths were associated in one way or another with the same potent painkiller.
- Each day approximately 5,500 individuals start abusing prescription pain medications.
- For those under 65 who died from an overdose of these drugs, over 830,000 years of potential life was lost.
- Individuals between the ages of 35 and 54 years had the highest death rate from prescription painkillers.
- Death rates from prescription pain medications for American Indians, Alaska Natives, and non-Hispanic whites were triple those of blacks and Hispanics whites.
- New Mexico had the highest number of deaths from painkiller overdose at 27 per 100,000 people (2008 data)
- The state with the lowest number of deaths from overdose was Nebraska, with only 5.5 per 100,000 people. Nebraska also had the lowest number of people using prescription pain medications for nonmedical purposes.
Other recent statistics reported by CNS News include:
- In 2007, out of approximately 28,000 deaths due to prescription drug overdoses, a significant number were from opioid pain medications.
- Deaths due to prescription drug abuse is now greater than deaths caused by motor vehicle accidents in the District of Columbia as well as 17 other states in the U.S.
All in all, these new numbers from the CDC and other reports reveal that every single day in the U.S. there are at least 40 deaths from an overdose of painkillers. That means more than 40 lives are cut short due to this epidemic problem each and every day. In addition to hydrocodone, other narcotic drugs contributing to the problem include oxycodone (e.g. OxyContin, Percodan, Tylox, Percocet), codeine, methadone, morphine, fentanyl (e.g. Duragesic, Sublimaze, Fentora), and oxymorphone (e.g. Opana, Numorphan HCl).
Underlying Aspects of the Problem
Ease of Access
Painkillers are one of the most widely prescribed types of drugs in the U.S. They have significant appeal because they are fast acting and potent. Individuals who have suffered a recent injury, undergone surgery, or who have a chronic pain condition find significant relief in these medications. They help prevent unnecessary suffering, improve quality of life, and allow millions of people to function at an adequate or normal level that wouldn’t be able to without them. In that regard, they serve their purpose well.
Unfortunately, this makes access to these drugs quite easy. Some individuals obtain them by doctor shopping. This means they seek out new doctors in order to obtain a prescription once their previous doctor is no longer willing to prescribe the medication.
Others obtain prescription pain medications from friends or relatives – either with our without their permission – who got them for legitimate reasons from their doctor. Medicine cabinets containing painkillers are often left unlocked. This makes it easy for a family member or friend who either lives in the home or is just visiting to obtain the pills without anyone ever realizing a few went missing. In fact, during 2008 and 2009, a reported 70% of individuals from age 12 on up who abused painkillers got them from a relative or friend.
Another underlying aspect of this growing epidemic of painkiller abuse is the misperceptions associated with these and many other prescription drugs. Many people – particularly adolescents – who would never touch “street drugs” like crystal meth or marijuana have a different view of prescription drugs. Since they are legal and prescribed by physicians, they are often assumed to be safer than illicit drugs. The risk for addiction or serious side effects from pain relievers is often believed to be much lower as well. Sadly, these misperceptions are extremely dangerous and couldn’t be further from the truth.
Fast, Pleasurable Effects
Not only do narcotics quickly and effectively relieve pain, they also provide very pleasurable effects. For example, one of the side effects of opioids is euphoria. Any substance that quickly induces a euphoric state has a high potential for abuse. This is one of the reasons painkillers are one of the most widely abused prescription drugs.
High Risk for Dependence, Tolerance, and Addiction
Unfortunately, we live in a society that demands and expects quick relief with little effort. Although there are many alternative ways to treat and manage pain, nothing is as easy as merely popping a pill. You don’t need any special training or expertise, and the results are fast. But this is another reason why prescription painkillers are not only highly abused, but also lead to dependence and addiction in many cases.
Every time someone in pain takes a medication like Vicodin or Percocet, he or she gets quick relief from the troubling – and sometimes unbearable – pain. Combine this relief with a feeling of euphoria as well, and the desire to repeat the experience becomes especially strong. Continued use of many pain medications can lead to tolerance, dependence, and addiction.
For those who are particularly desperate or who have a very low tolerance for pain, there is significant temptation to take more medication than prescribed or to take it more frequently than prescribed. Unfortunately, this often leads to a tolerance – which means that in order to achieve the same effect, the person must use more of the medication.
Physical dependence may also develop, which means that one’s body has adapted to the medication. When someone is dependent on a medication, withdrawal symptoms occur when it is suddenly stopped or significantly decreased. These unpleasant symptoms may include difficulties thinking clearly, stomach cramps, nausea and vomiting, and diarrhea.
Addiction, which is different than dependence, can occur with many pain medications. When people are addicted they do one or more of the following things:
- Crave the drug
- Have little or no control over their use of the drug
- Feel compelled to continue using the drug
- Keep using the drug even though it is causing social, mental, or physical problems
Highly Addictive Pain Medications on the Market
Currently, there are many painkillers on the market that are very addictive. Some of the most addictive ones include OxyContin, MS Contin, fentanyl, Demerol, Vicodin, Lorcet, and Percocet. However, a new painkiller which is reported to be 10 times as potent as Vicodin may soon become available as well. It is causing significant concern in terms of its great potential for abuse and addiction.
The brand name for this new painkiller is Zohydro. It is an extended release form of hydrocodone (generic name: hydrocodone bitartrate). Zohydro is currently in its third phase of clinical testing. Unlike other hydrocodone products which usually contain acetaminophen, this new drug is essentially pure hydrocodone. Addiction experts are concerned that, like OxyContin, those inclined to abuse the drug will create a fine powder by crushing the pills. The powder can then be snorted in order to produce a powerful high.
One of the pharmaceutical companies testing Zohydro is Zogenix. On their website they argue that high amounts of acetaminophen can lead to liver toxicity. While this is true, opponents may argue that the argument is a diversion from the more serious issue. Zogenix, along with three other companies testing this potent new painkiller, also argues that anyone taking it will be highly supervised by his or her physician. Unfortunately, this won’t necessarily prevent it from potentially becoming a widely used drug of abuse.
Current Measures and Potential Solutions
The Obama Administration has recently released an action plan entitled “Epidemic: Responding to America’s Prescription Drug Abuse Crisis” in order to address the problem. Forty-eight states have taken measures outlined in the plan, including setting up programs designed to monitor things like doctor shopping. The Justice Department has been actively taking down “pill mills” to help reduce illegal production and distribution of these drugs. Also, the “Secure and Responsible Drug Disposal Act” was recently signed by President Obama.
Individuals can also help by using appropriate means of disposing medications that have either expired or are no longer necessary for medical purposes. Parents, teachers, and health care professionals can talk to children and adolescents about the dangers of abusing painkillers as well as other types of prescription medications.
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