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Senior Citizen Health & Medicine
Prescription Pain Killers: Illicit Use and Deaths
Increasing Say Two New Reports
Senior citizens mostly uninvolved as drug abuse and
under treated pain become public health crises
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Misused Pain
Relievers |
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Specific
Types of Pain Relievers Used during the Past Year among
Initiates of Non-medical Use of Pain Relievers: 2004
Source SAMHSA
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July 24, 2006 Two recent reports show a
significant jump in the use of prescription pain killers for uses other
than prescribed medical treatment. But senior citizens, which many would
assume to be among this growing trend, due to the large number that
suffer with pain and rely on drugs for relief, just do not seem to be
involved.
A report released today says trends analysis of
drug poisoning deaths has helped explain a national epidemic of overdose
deaths in the US that began in the 1990s. This conclusion was by Leonard
Paulozzi and colleagues at the Centers for Disease Control and
Prevention. The contribution of prescription pain killers to the
epidemic has only become clear recently, the study says.
Drugs called "opioids" are frequently prescribed to
relieve pain, but if abused they can kill. Over the past 15 years, sales
of opioid pain killers, including oxycodone (OxyContin), hydrocodone
(Vicodin), methadone and fentanyl, have increased, and deaths from these
drugs have increased in parallel.
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 |
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65 or older |
60-64 |
55-59 |
50-54 |
45-49 |
40-44 |
35-39 |
30-34 |
26-29 |
|
2003 |
0.4 |
1.6 |
0.8 |
2 |
4.4 |
3.8 |
4.9 |
5.4 |
7.8 |
|
2004 |
0.4 |
0.4 |
1.7 |
1.6 |
3.6 |
4.1 |
4.1 |
5.5 |
7.6 |
|
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In 2002, over 16,000 people died in the US as a
result of drug overdoses, with most deaths related to opioids, heroin,
and cocaine. Opioids surpassed both cocaine and heroin in extent of
involvement in these drug overdoses between 1999 and 2002.
This increase in deaths from drug overdoses is
particularly alarming when combined with the government report released
last month alerting America that 2.4 million Americans initiated the
non-medical use of narcotic pain relievers in the past year more than
marijuana or cocaine. Interestingly, the findings show, however, that
senior citizens are just not nor do they appear to have ever been a
significant factor in the use of narcotic pain relievers.
This report from the Substance Abuse and Mental
Health Services Administration that extracted data from the 2004
National Survey on Drug Use and Health was released June 19.
The report, "Nonmedical Users of Pain Relievers:
Characteristics of Recent Initiates," shows that 2.4 million persons
ages 12 or older initiated non-medical use of prescription pain
relievers in the 12 months prior to the survey, 2.1 million initiated
use of marijuana, and 1 million initiated use of cocaine.
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The SAMHSA report also shows that 48 percent of new
initiates used Vicodin, Lortab or Lorcet; 34.3 percent used Darvocet,
Darvon, or Tylenol with codeine; 20 percent used Percocet, Percodan or
Tylox; 18.4 percent used generic hydrocodone; 14.3 percent used generic
codeine; 8.4 percent used Oxycontin; and 4.3 percent used morphine. Over
half of persons who initiated non-medical use of pain medications (54.9
percent) in 2004 were female.
Further, the report found that only 26.2 percent of
the new initiates to pain medications started using pain relievers as
their first illicit drug of abuse. Marijuana was used by 66.2 percent
prior to starting narcotic pain medications; hallucinogens were used by
24.9 percent; and inhalants were used by 21.3 percent.
The deaths from this increased use also appear to
be accelerating, according to today's report from the CDC data.
Between 1979 and 1990 the rate of deaths attributed
to unintentional drug poisoning increased by an average of 5.3% each
year.
Between 1990 and 2002, the rate increased by 18.1%
per year.
The contribution played by opioids is also
increasing. Between 1999 and 2002 the number of overdose death
certificates that mention poisoning by opioid pain killers went up by
91.2%. While the pain killer category showed the greatest increase,
death certificates pointing a finger of blame at heroin and cocaine also
increased by 12.4% and 22.8% respectively.
This research is published this week in the
journal, Pharmacoepidemiology and Drug Safety.
In an accompanying 'comment' article, David
Joranson and Aaron Gilson of the University of Wisconsin School of
Medicine and Public Health Comprehensive Cancer Centre; Pain & Policy
Studies Group, of Madison, Wisconsin. They caution against increasing
unwarranted fears of using opioid analgesics in pain management, noting
that much of the abuse of opioid analgesics is by recreational and
street users and individuals with psychiatric conditions rather than
pain patients.
Joranson and Gilson also point to the large
quantity of opioid analgesics stolen from pharmacies every year, saying
that "overdose deaths involving prescription medications do not
necessarily mean they were prescribed. It is also crucial to know that
most overdose deaths involve several drugs and these data cannot
attribute the cause to a particular drug."
In a second commentary, Scott Fishman, Professor of
Anaesthesiology and Pain Medicine at University of California, Davis
concludes that drug abuse and under treated pain are both public health
crises, but the solution to one need not undermine the other. "The least
we can do is make sure that the casualties of the war on drugs are not
suffering patients who legitimately deserve relief," he says.
External Links:
About Opioids from Psychology Today
The Opioids are a class of controlled
pain-management drugs that contain natural or synthetic chemicals based
on morphine, the active component of opium. These narcotics effectively
mimic the pain-relieving chemicals that the body produces naturally.
Opioids are the most often prescribed
pain-relievers because they are so effective. Moreover, many studies
have shown that opioid analgesic drugs are safe and rarely cause
clinical addiction or compulsive usage if taken as directed.
Morphine, heroin, codeine and related drugs are
among the opioids. Morphine is frequently prescribed to alleviate severe
pain after surgery. Codeine can be helpful in soothing somewhat milder
pain, as are oxycodone (OxyContin, an oral, controlled-release form of
the drug), propoxyphene (Darvon), hydrocodone (Vicodin), hydromorphone
(Dilaudid) and meperidine (Demerol), which is used less often because of
its side effects. Diphenoxylate or Lomotil can also relieve severe
diarrhea, and codeine can ease severe coughs.
Read more from special section on Opioids in Psychology Today
2.4 Million Started Using Pain Relievers in Past
Year
 June 19, 2006 - More persons initiated non-medical
use of narcotic pain relievers in the past year than initiated use of
marijuana or cocaine. This is the finding of a new report from the
Substance Abuse and Mental Health Services Administration that extracted
data from the 2004 National Survey on Drug Use and Health.
The new report, Nonmedical Users of Pain
Relievers: Characteristics of Recent Initiates, shows that 2.4 million
persons ages 12 or older initiated non-medical use of prescription pain
relievers in the 12 months prior to the survey, 2.1 million initiated
use of marijuana, and 1 million initiated use of cocaine.
The report is available on the web -
click here
Prescription of Opioids For Back Pain Needs
Improvement
April 15, 2004 - Physicians' prescriptions of
opioid drugs for back pain are inconsistent, found a Duke University
Medical Center study, the largest and most comprehensive of its kind.
The study found significant regional, social and economic disparities in
the use of the powerful painkillers. Specifically, the researchers found
that patients are more likely to take opioid drugs for their back pain
if they live in the South, hold public insurance, are less educated and
have low income. Moreover, the use of a powerful opioid drug, oxycodone,
doubled from 1996 to 1999, found the researchers.
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