Prescription Drug Overdoses Reach Epidemic Levels

Kate H. Gamble, Senior Editor
Published Online: Friday, November 4, 2011
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The number of deaths resulting from overdoses of prescription painkillers has more than tripled in the past decade, according to a CDC Vital Signs report, which found that more than 40 people die every day from overdoses involving narcotic pain relievers such as hydrocodone, methadone, oxycodone, and oxymorphone.

“Overdoses involving prescription painkillers are at epidemic levels and now kill more Americans than heroin and cocaine combined,” said CDC Director Thomas Frieden, MD, MPH, in a statement. “States, health insurers, health care providers and individuals have critical roles to play in the national effort to stop this epidemic of overdoses while we protect patients who need prescriptions to control pain.”

The increased use of prescription painkillers for nonmedical reasons, along with growing sales, has contributed to the large number of overdoses and deaths. In 2010, 1 in every 20 people in the United States age 12 and older—a total of 12 million people—reported using prescription painkillers nonmedically, according to the National Survey on Drug Use and Health. Based on the data from the Drug Enforcement Administration, sales of these drugs to pharmacies and health care providers have increased by more than 300% since 1999.

“Prescription drug abuse is a silent epidemic that is stealing thousands of lives and tearing apart communities and families across America,” said Gil Kerlikowske, Director of National Drug Control Policy. “Health care providers and patients should be educated on the risks of prescription painkillers.”

In April, the Administration released a comprehensive action plan to address the national prescription drug abuse epidemic to reduce this public health burden. The plan includes support for the expansion of state-based prescription drug monitoring programs, more convenient and environmentally responsible disposal methods to remove unused medications from the home, education for patients and healthcare providers, and support for law enforcement efforts that reduce the prevalence of "pill mills" and doctor shopping.

Already, 48 states have implemented state-based monitoring programs designed to reduce diversion and doctor shopping while protecting patient privacy and the Department of Justice has conducted a series of takedowns of rogue pain clinics. President Obama has also signed into law the Secure and Responsible Drug Disposal Act, which will allow states and local communities to collect and safely dispose of unwanted prescription drugs and support DEA’s ongoing national efforts to collect unneeded or expired prescription drugs which have collected over 300 tons of medications over the past year.

In its latest report, the CDC found that prescription painkiller death rates among non-Hispanic whites and American Indians/Alaska Natives were 3 times those of African-Americans and Hispanic whites. In addition, the death rate was highest among individuals aged 35 to 54 years.
Findings from analysis of state data on fatal drug overdoses, nonmedical use of prescription painkillers, and sales of prescription painkillers to pharmacies and health care providers uncovered the following:
  • State death rates from overdoses (from 2008 data) ranged from a high of 27.0 deaths per 100,000 people in New Mexico to a low of 5.5 deaths per 100,000 people in Nebraska.
  • Nonmedical use of prescription painkillers ranged from a high of 1 in 12 people aged 12 and older in Oklahoma to a low of 1 in 30 in Nebraska. States with more nonmedical use tend to have more deaths from drug overdoses.
  • Prescription painkiller sales per person were more than 3 times higher in the highest state, Florida, than in the lowest state, Illinois. States with higher sales per person tend to have higher death rates from drug overdose.
The CDC recommends that states take the following steps to help prevent overdoses from prescription painkillers and reduce this public health burden:
  • Start or improve prescription drug monitoring programs, which are electronic databases that track all prescriptions for painkillers in the state.
  • Use prescription drug monitoring programs, public insurance programs, and workers’ compensation data to identify improper prescribing of painkillers.
  • Set up programs for public insurance programs, workers’ compensation programs, and state–run health plans that identify and address improper patient use of painkillers.
  • Pass, enforce and evaluate pill mill, doctor shopping and other state laws to reduce prescription painkiller abuse.
  • Encourage professional state licensing boards to take action against inappropriate prescribing.
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