A new study shows that Americans are receiving far more painkillers than they need by doctors and as a consequence they are sharing them with others leading to addiction and a pattern that is become nearly an epidemic. Painkillers like Vicodin and OxyContin are being shared and little good comes from this illegal behavior.
U.S. opiate use continues to rise
Having lived outside of the United States for many years it would be fairly easy to be unaware of the scope of opiate abuse occurring in the country. However, it’s been widely reported including the rise in heroin use coast-to-coast often owing to addictions to OxyContin and the relative “ease” by which to secure heroin over a prescription medication. Hell, heroin is also cheaper. I was shocked in March when I turned on the Miami CBS affiliate that my local Guatemalan cable offers to watch the Final Four and saw an advertisement for a medication whose sole advertised purpose was to relieve constipation caused by opiate use.
That’s not a cheap time slot for an advertisement and showed me the scope of opiate abuse and its over prescribing by physicians in the United States. Additionally, I wrote here a few months ago that life expectancy declined for the first time in over three decades owing to suicide and opiate overdoses. The last time there was a decrease in life expectancy came as a result of the AIDS outbreak which for most proved fatal quite quickly unlike today. Between 1999 and 2014, fatal opiate-based painkiller overdoses have tripled according to the U.S. Centers for Disease Control and Prevention.
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The study surveyed over 1,000 adults who were prescribed opiate-based painkillers like OxyContin and showed that over half were prescribed more than were needed. Over 20% of those survey said that “they have shared an opioid medication with another person, primarily to help that other person manage pain,” said author Alene Kennedy-Hendricks whose writings were published in the June 13 online issue of JAMA Internal Medicine.
Additionally, over 60% of those with left over pills saved them for later use rather than simply throwing them away when the pain was gone. Most received no instructions, or didn’t remember any instruction of the safe storage of opiates from the prescribing doctor.
Survey details and a second study
The survey was conducted 2015 with 1,055 patients who received opiates in the year prior, a shocking 47% were still taking opioids when the they were surveyed.
For decades, and with some evidence to back it up, marijuana was described as a gateway drug suggesting that users would move on to stronger drugs like cocaine and heroin. That could be argued all day but there is no arguing that painkillers have caused a spike in heroin use as its generally cheaper than prescription medications and provides the opiate addict with a fix that is more readily accessible and a scourge all over the country.
“We need to make it easier and more convenient for people to dispose of their leftover opioid medication,” said Kennedy-Hendricks. “There have been efforts in recent years to expand drop-off sites and approved collectors, but perhaps it has not been enough.”
“There is,” said Dr. Anupam Jena, an associate professor of health care policy and medicine at Harvard Medical School “a wealth of evidence that opioids are obtained from physicians in the outpatient setting, sometimes multiple physicians, from friends and family, family members, from the internet, and from illicit sources.”
Jena and his colleagues also published a study in JAMA Internal Medicine yesterday after surveying 600,000 Medicare recipients and found that a full 15% were given strong opioids at the time of hospital discharge. What really jumped out in their study was the fact that about 43% were still taking them over three months later. The 15% had not been taking opioids the two months prior to hospital admission.
“Our findings,” said Jena, “corroborate prior work that suggests that short-term exposure to opioids can lead to long-term use and, at worse, dependence.”
Many people are blaming the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) initiative, which asks patients about their pain and often prescriptions follow.
As a result of the HCSHPS initiative the Promoting Responsible Opioid Prescribing Act of 2016 was passed to look into the initiative.
To understand the gravity of abuse Jena issued a statement with the study’s release.
“Every day, 44 people in the United States die from prescription drug overdoses, especially opioid overdose. It’s critical that we understand hospital prescribing patterns so that we can make sure we are prescribing these medications safely and effectively without fueling this deadly crisis,” said Dr Jena in a Harvard news release.