From 2003 to 2013, the percentage of nonmedical use of prescription opioids decreased among adults in the US, while the prevalence of prescription opioid use disorders, frequency of use, and related deaths increased, according to a study in the October 13 issue of JAMA. The proportion of prescription opioid users with use disorders also increased, from 12.7% to 16.9%.
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To investigate prevalence and related risk factors, they looked at data from 472,200 participants in the 2003-2013 National Surveys on Drug Use and Health (NSDUH). Mortality was based on the 2003-2013 National Vital Statistics System’s Multiple Cause of Death Files.
Among adults age 18 through 64 years, the prevalence of nonmedical use of prescription opioids decreased from 5.4 percent in 2003 to 4.9 percent in 2013, but the prevalence of prescription opioid use disorders increased from 0.6 percent in 2003 to 0.9 percent in 2013. The 12-month prevalence of high-frequency use (≥200 days) also increased from 0.3% (95% CI, 0.19%-0.35%) in 2003 to 0.4% (95% CI, 0.31%-0.48%) in 2013 (absolute difference, 0.1%; 95% CI, 0.01%-0.29%). But the hike in misuse, and use disorders in the new study points to more patients experiencing an inescapable progression from their initial opioid use to one of frequent use.
Drug overdose death rates involving prescription opioids increased from 4.5 per 100,000 in 2003 to 7.8 per 100,000 in 2013.
While prescription opioid use for nonmedical reasons reportedly fell in the decade between 2003 and 2013, the overall rates of usage disorders and deaths from misuse of the drugs rose at the same time, according to a new study reported by Reuters. Patients with opioid-related disorders and associated substance use disorders – plus nicotine dependence and depression – should be screened for treatment.
The Centers for Disease Control and Prevention recently granted 16 states a total of $20 million to study safe prescribing practices and reduce the availability of prescription opioids, they wrote.
“The results underscore the importance of addressing the prescription opioid crisis”, said lead author Dr. Beth Han of SAMHSA.
Previous studies have shown a strong relationship between inappropriate opioid prescribing and negative health outcomes; the current trend has occurred at a time when the quantities of opioids prescribed has increased. A toolkit has been developed by SAHMSA for preventing overdose of opioid. In fact, treatment rates have remained essentially static since 2004, said the researchers from Johns Hopkins School of Public Health in Baltimore.
Dr. Han and others who have studied the growing opioid epidemic have urged increased access to medication in a manner similar to methadone clinics. “We also need to think about changing the conversation about opioid addiction, which is a chronic relapsing illness, just like diabetes”.
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However, in the same timeframe, more of those who said they abused prescription narcotics abused them more frequently (0.6 percent in 2003 and 0.9 percent by 2013).
