The abuse and misuse of prescription painkillers is rapidly increasing—with deadly results.
According to the U.S. Centers for Disease Control and Prevention (CDC), overdoses of prescription painkillers have more than tripled in the past 20 years, killing more than 15,500 people in the United States in 2009. In fact, more people die from prescription opioid painkillers than from heroin and cocaine combined (45 deaths each day).
Emergency-room visits for prescription painkiller abuse or misuse have doubled in the past five years, to nearly half a million. About 12 million Americans reported using prescription painkillers for nonmedical reasons or simply to get high. And nonmedical use of prescription painkillers costs more than $72.5 billion each year in direct healthcare costs.
In observance of National Poison Prevention Week, which runs from March 16 to March 22, the National Safety Council (NSC) is warning the public about the dangers of prescription opioid painkiller use.
Don Teater, M.D., a family physician and NSC’s medical advisor, told Healthline, “The CDC has called this an epidemic because there are so many people dying from this now. Overdose is the number one cause of unintentional death in our country, and it is increasing dramatically.”
According to the NSC, the U.S., which contains only 4.6 percent of the world’s population, takes 80 percent of the world’s opioids and 99 percent of the world’s hydrocodone.
Teater, who treats people addicted to pain medications, said the majority of patients who started abusing painkillers obtained a prescription from their physician. “If they have stress in their life, it makes them feel better. If a guy is hurting and he’s not able to work and is worried about making ends meet, it makes him feel better.”
Unfortunately, many people assume that these drugs are completely safe, Teater said. “Even in the medical community, it’s erroneously believed these are safe medications. We need to get doctors back into the habit of prescribing non-addicting pain relieving pills instead of the addicting ones.”
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He added, “Twenty years ago, we prescribed painkillers for cancer pain, for people who had severe end-of-life kind of issues—but nowadays we are using it for any kind of pain. It’s a very addicting medicine.”
Noting that pain serves a purpose in telling us something is wrong, Teater said, “Most of the time those pains can be taken care of with over-the-counter medications that work as well as these dangerous medications.”
Janet P. Engle, PharmD, FAPhA, head of the Department of Pharmacy Practice at the University of Illinois at Chicago, told Healthline that that number of people who abuse prescription drugs is surpassing the number of people who abuse cocaine, hallucinogens, ecstasy, inhalants, and heroin combined.
“Statistics show that 70 percent of people who abuse prescription pain relievers received them from a friend or family member,” she added.
According to the NSC, one in eight high school seniors say that they are using prescription painkillers for recreational use.
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Experts say it’s important for patients, family members, and the general public to learn how to safely and appropriately use and store their prescription drugs in order to protect themselves and others from the dangers of prescription medicine abuse.
Engle advised that even if a family member, friend or neighbor has the same type of condition as you, it is very dangerous to share prescription medicines. “They may be taking a drug that interacts with the medicine you give them or may have a condition that could worsen if they take certain medicines. By sharing prescription drugs to relieve their pain, you may be masking an injury and delaying a necessary visit to the doctor,” said Engle.
Finally, Engle cautioned that it’s important to read the label, follow the directions, and never take more medicine than is recommended on the label. “These products should not be taken for more than 10 days for pain unless directed by a doctor,” she said.
Addiction to prescription painkillers can lead to heroin use, because heroin, while also an opioid, is usually less expensive than prescription medications.
While healthcare professionals agree that preventing prescription painkiller medication abuse is a serious matter, they also want to safeguard access to these medications for people who really need them, such as those who suffer from chronic pain due to an injury or illness.
To that end, The National Association of Chain Drug Stores (NACDS) recently offered its support for new legislation—the Ensuring Patient Access and Effective Drug Enforcement Act of 2013 (H.R. 4069)—that calls for a collaborative, coordinated approach to curbing prescription drug abuse and safeguarding patients.
U.S. House of Representatives Energy and Commerce Committee Vice Chair Marsha Blackburn (R-TN) and Rep. Tom Marino (R-PA) introduced the legislation. The bill would establish a workgroup to explore opportunities to reduce prescription drug abuse without comprising access to medications for patients who legitimately need them.
“This legislation is an important step in addressing one of the most complex public health problems of our day,” said NACDS president and CEO Steven C. Anderson.
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In a related development, controversy continues to rage over the approval in 2013 of Zohydro ER (hydrocodone bitartrate extended-release capsules), the first extended-release, hydrocodone-only product approved by the U.S. Food and Drug Administration (FDA).
On one side, leaders are urging the FDA to withdraw approval of the drug, citing its likelihood to increase the drug abuse epidemic. Sen. Joe Manchin, D-W. Va., introduced a bill that would force the FDA to withdraw the drug and prohibit the approval of any similar medications that don’t have tamper-resistant design features.
In a letter to FDA Commissioner Margaret Hamburg, Vermont Governor Peter Shumlin and several of the state’s mayors urged the FDA to assess and withdraw its approval of Zohydro, saying that the drug is “likely to exacerbate the drug abuse epidemic facing our state and the nation.”
Commissioner Hamburg’s response to Senate lawmakers has been that the recently launched Zohydro fills an “important and unique niche” for treating chronic pain.
Weighing in on Zohydro, Teater said, “The problem is it’s a pill that’s very easy, for people who are already addicted, to snort up their nose or inject into their vein, and it gives a very fast high. In the doses that it’s coming in, that might be a fatal dose for people.”
Noting that Oxycontin and other strong, long-acting opioid medications are available, Teater said, “Zohydro doesn’t add any benefit and it appears to be more dangerous for those people who take the first pill and have never taken drugs before…There is no need for it and we are certain it will cause people to die.”