Prescription Drug Overdose Deaths on the Rise

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Accidental drug overdose deaths are on the rise in the United States; in about 20 states in 2007, the number of unintentional drug overdose deaths exceeded motor vehicle crashes or suicide, two of the leading causes of injury and death. Many of these poisonings are due to overdoses of opioid pain medications, such as OxyContin and Vicodin. These types of drugs accounted for about 36 percent of all poisoning deaths in the United Stats in 2007.

Physicians from the U.S. Centers for Disease Control and Prevention, the University of North Carolina at Chapel Hill School of Medicine, and Duke University Medical Center wrote in a commentary article in the Journal of Clinical Psychiatry that in 2007, accidental deaths due to opioid painkillers accounted for more unintentional deaths than heroin and cocaine combined.

In 2007, about 27,500 people died from accidental drug overdoses, mainly due to opioid painkiller overdoses. Richard H. Weisler, MD, adjunct professor of psychiatry at UNC and adjunct associate professor of psychiatry at Duke University Medical Center, said that in 2007, almost 5 times more people died from accidental drug overdoses than U.S. fatalities in both Operation Iraqi Freedom and Operation Enduring Freedom in Afghanistan. Another way of looking at it is this: The number of people who died from accidental overdose in 2007 is equivalent to about 155 people dying every day for six months.

In June 2010, the CDC announced that their 2009 National Youth Risk Behavior Survey found that one in five high school students in the United States have abused prescription drugs, including opioid drugs OxyContin, Percocet, and Vicodin. They also reported that visits to emergency departments involving prescription drug abuse increased by 111 percent from 2004 to 2008.

The researchers said that reasons for the increase may include increased abuse of opioids without a prescription (using the drugs to “get high”), and that health care providers may be failing to screen patients for signs of substance abuse, or to look for the overlap between mental illness and substance abuse. For example, 15 to 30 percent of people with mental health issues such as anxiety, bipolar disorder, and ADHD also have substance abuse problems.

Ashwin A. Patkar, MD, associate professor in the psychiatry and behavioral sciences department at Duke University, said that people with substance abuse problems are also more likely to suffer from another mental illness, and many chronic pain patients also have mental illness or substance abuse problems.

The authors also note that opioids, benzodiazepines, anti-depressants, and sleep aids are often prescribed in combination despite their potential for addiction. These combinations of drugs are also commonly reported in overdose deaths.

The researchers recommend that doctors should aim to prescribe non-narcotic medications and physical therapy, exercise, and other non-medicinal methods before prescribing opioids for pain. They concluded that it is extremely important to screen chronic pain patients who may need opioid therapy for substance abuse and mental health problems and then address these problems individually.

Science Daily, Narcotic Pain Relief Drug Overdose Deaths a National Epidemic, pril 25, 2011

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