Where Are All The Prescription Pills Coming From? Soaring Overdose Rates Prompt CDC Probe
Health officials said on Wednesday that an alarming number of prescription drug abusers get these drugs from friends and family, providing more evidence that pharmaceutical pills are inching further away from the experts who are supposed to administer them.
The Centers for Disease Control and Prevention (CDC) said that the findings come from a review of four years of nationwide health surveys on nonmedical use of prescription pills. Today, a mere 15 percent of frequent abusers say they buy from drug dealers or other strangers. One in four users doctor-shop for prescriptions — but just as many get them for free from friends or relatives.
"At this point, virtually everyone recognizes that this is a serious problem that has been getting much worse," Dr. Tom Frieden, director of the CDC, said in an interview with the Los Angeles Times. "What we now are figuring out is what’s going to work to reverse it."
The agency’s new study, which is published in the journal JAMA Internal Medicine, focused on opioids — a family of painkillers that include OxyContin and Vicodin. "These results underscore the need for interventions targeting prescribing behaviors, in addition to those targeting medication sharing, selling and diversion,” the researchers said in a press release. “The essential steps health care providers can take to curb this serious health problem include more judicious prescribing, use of prescription drug-monitoring programs and screening patients for abuse risk before prescribing opioids."
The CDC’s new review goes to the core of an issue that has kept public health officials sleepless for years. Since 1999, overdose deaths involving prescription painkillers have tripled, with more than 16,000 fatalities in 2010. The problem is not limited to analgesics: psychiatric medication, for example, currently account for more emergency room deaths than street drugs.
And like painkillers, psychiatric medication frequently follows less than ideal routes. Dr. Allen Frances, a psychiatrist and former chairman at the American Psychiatric Association, says that 80 percent of psychiatric pills are now prescribed by primary care physicians rather than psychiatrists. This ultimately contributes to an influx of pills that can have serious side effects and high addiction potential.
Frieden believes that the situation can be turned around — but in order to make that happen, authorities must devote more energy to prescriptions drug monitoring programs (PDMPs) that help physicians spot abusers. "There is a coalescing recognition of what’s going to be important," he told reporters. "One is clearly going to be PDMPs — and PDMPs that are mandatory, real-time and actively monitored so that the folks running them identify problem patients and problem doctors."
Source: Jones CM, Paulozzi LJ, Mack KA. Sources of Prescription Opioid Pain Relievers by Frequency of Past-Year Nonmedical Use. JAMA Internal Medicine. 2014.