For a long time, heroin was the chic way to overdose on opioids, but urban adults are setting a new trend toward “designer” drugs straight from the pharmacy.

The U.S. Food and Drug Administration—the agency responsible for approving and regulating prescription drugs—states that in 2009 alone, more than 15,500 Americans died after overdosing on narcotic pain relievers.

Prescription drug overdoses kill more white and Hispanic men each year than suicide and motor vehicle accidents, according to a new report from Columbia University's Mailman School of Public Health.

Researchers used data from New York City’s chief medical examiner’s office for the period 1990-2006, and found that during that 16-year period, the rate of overdose from analgesic opioids went up seven-fold. The findings were published last week in Drug and Alcohol Dependence. 

“This has been seen as much more of a rural problem, but these numbers show that it is much more of an urban problem than we believed,” Magdalena Cerdá, DrPH, lead study author and assistant professor of epidemiology at Columbia's Mailman School of Public Health, said in an interview with Healthline. “We need to address the use of prescription drugs in urban areas.”

A Specific Type of Opioid

A class of opioids called analgesics, which includes codeine, hydrocodone, morphine, and oxycodone, are most commonly used as pain relievers. They are often prescribed for chronic pain or intense, acute pain, such as a broken leg or post-surgery pain. They are also highly-addictive.

Before the appearance of opioids in prescription form, opiates were either smoked or injected as heroin. Drugs that require smoking or injecting are unlikely to attract the same crowd as prescription opiates, Cerdá said.

“I do believe a big misconception with these drugs is that people believe they are safe because they are not illegal, so they don’t carry the same stigma that heroin has,” she said. “Part of [the purpose of] this study is to raise awareness that this is a growing problem among adolescents.”

The use of prescription opioids is nothing new. They’ve appeared in the lyrics of hip-hop songs by Little Wayne and Macklemore and in documentaries such as The OxyContin Express. Long before they entered pop culture, prescription drugs became popular among youth because they're relatively easy to get. Often, they’re sitting right in your medicine cabinet.

Researchers are most concerned about the sheer number of pills circulating through major metropolitan areas that are being consumed for recreational use, not to treat pain as prescribed by a doctor. More research will be required to identify exactly where the pills originate and how they circulate through communities.

Cerdá said that prescription opioids are the second-most used drugs in America, with marijuana being the first. However, there are many prevailing misconceptions about prescription pill abuse and its deadly consequences.

The Biggest Misconception

The stats read like the plot of a Bret Easton Ellis novel: white, affluent males taking pricer pharmaceutical drugs they believe they are safer to use than street drugs.

The Columbia report states that whites are nearly three times more likely to overdose on analgesics than any other race, and the deaths associated with overdose occur in areas with high income inequality.

“A possible reason for the concentration of fatalities among whites is that this group is more likely to have access to a doctor who can write prescriptions,” Cerdá said. “However, more often than not, those who get addicted have begun using the drug through illicit channels rather than through a prescription.”

Researchers noted that analgesics are cheaper than other opioids like heroin, and that their use is fueled by the mistaken belief that prescription drugs in general are safer than street drugs because they come from a pharmacy, not some guy you went to high school with.

Combating Overdoses

The Columbia researchers made the following recommendations to help curb opiate misuse:

  • regulate the aggressive marketing of potent drugs like Oxycontin
  • control the over-prescribing of analgesics
  • take stricter measures to regulate drug sales
  • increase law enforcement measures to identify illicit distribution networks for these drugs
  • provide educational outreach for physicians and patients

Cerdá recommends that parents speak to their children about the dangers of all drugs, including those made in a laboratory and prescribed by a doctor.

“When parents are talking to their kids about drugs, it’s an important lesson that they talk about prescription abuse as well,” she said. 

Regulators are also beginning to take note of the rise is prescription painkiller abuse. In January, an FDA advisory panel voted 19-10 to impose greater restrictions on access to hydrocodone, the active ingredient in Vicodin, but the FDA has not said if or when it will follow the panel's advice, USA Today reported

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