The Overdose Epidemic: Heroin and Prescription Drugs



Prescription Drug Overdose Deaths Up for the 11th Straight Year

Overdose deaths from prescription drugs increased in 2010 for the 11th straight year, and doctors don't expect this troubling trend to slow down.

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WEDNESDAY, Feb. 20, 2013 —Prescription drug abuse is the fastest growing drug problem in the United States, and as more and more people become addicted to prescription drugs, the number who die from overdoses will increases as well, experts say. A new report by the U.S. Centers for Disease Control and Prevention found that number of people who died from prescription drug overdoses went up again in 2010, marking the 11th year in a row the numbers have increased.

The CDC report, published in theJournal of the American Medical Association, details the alarming increase in the number of overdose deaths from opioids, such as OxyContin and Vicodin, and benzodiazepines, such as Xanax, which made up the vast majority of prescription drug overdoses. Antidepressants, antiepileptic, and anti-parkinsonism drugs also played a role in the OD increases.

Researchers found that in 2010, 38,329 people died from drug overdoses in the United States, an increase of 3.9 percent over the previous year.Of those who died in 2010, nearly 60 percent overdosed on pharmaceutical drugs, more than the number of people who died from overdosing on heroin and cocaine combined something that didn’t surprise the researchers.

“We’ve been monitoring this closely, and seeing that, as sales have continued to increase, so have deaths,” says Christopher Jones, Pharm. D., study author and CDC researcher. “There’s been a threefold increase in supply of these drugs [since 1999], so we thought it’d be likely that overdose deaths would have continued to increase.”

Suicide Watch for Rx Drug Abusers

Dr. Jones and his team found that the majority of overdoses were accidental, but 17 percent were considered suicide. He says the suicide number underscores the need for mental screening of people prescribed these drugs, especially opiates and benzodiazepines, to ensure that they are not a danger to themselves.

“We do know that patients with mental health issues have an increased risk for non-medically using these drugs, and they’re also more likely to increase their own dose,” says Jones. “Identifying these issues before prescribing and addressing these issues during treatment is important.”

While many people with legal prescriptions for painkillers and other medicines abuse them, more often than not, the overdose deaths occur in people without valid prescriptions, the CDC said on its website.

“Almost all prescription drugs involved in overdoses come from prescriptions originally; very few come from pharmacy theft,” according to the CDC site. “However, once they are prescribed and dispensed, prescription drugs are frequently diverted to people using them without prescriptions. More than three out of four people who misuse prescription painkillers use drugs prescribed to someone else.”

Since 1999, there has been a 300 percent increase in prescription drug sales, according to the CDC, which mirrors the rise in prescription drug overdoses. And as long as doctors continue to prescribe these prescription drugs en masse, people will continue to sell them, says Thomas Brouette, MD, assistant professor of psychiatry at SUNY Downstate in New York City.

“The thing that decides what drug people use is availability,” says Dr. Brouette. “More opiates are being prescribed and sitting in peoples medicines cabinets, so it’s become easier to find someone who is selling them.”

The Doctors' Dilemma: Undertreating vs. Overtreating Pain

However, getting doctors to cut back on prescribing these powerful drugs may be difficult. Many doctors prescribe them due to fear of patient dissatisfaction and litigation if they don’t, says Jason Jerry, MD, staff physician in the Alcohol & Drug Recovery Center at Cleveland Clinic.

“We’ve created this situation through the undertreatment of pain,” Dr. Jerry says. “There have been several lawsuits for physicians undertreating pain that created the situation in which doctors are much safer erring on the side of prescribing narcotics versus not prescribing them.”

But in order to cut addiction rates, Jones says, it's important for doctors to cut back on prescribing opioids and similar drugs, and to help educate patients so they understand that the pills can be addictive.

"I think from a patient perspective, it’s about appreciating that these drugs do have risks," says Jones.






Video: Mayo Clinic Minute: Heroin Overdose Drug

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