10 things to know about prescription opioid abuse in the United States

Pain Management

For years, physicians have been prescribing opioids as a way to combat pain, yet this feeds into our nation's serious, often fatal, opioid abuse problem. The number of prescription opioid abusers is spiking, and healthcare professionals are addressing this problem head-on, to avoid unnecessary casualties.

Here are 10 things to know about opioid abuse:


1. In the United States, approximately 2.1 million people abuse opioids, according to the National Institute on Drug Abuse. There are 26.4 million people abusing opioids around the world. The number of deaths in the United States due to prescription opioid pain relievers has tripled in the last 20 years, with opioid analgesic poisoning resulting in more deaths each year than heroin or cocaine. The United States alone consumes 99 percent of the world's hydrocodone pills as well as 80 percent of the world's prescription opiates.


2. The CDC estimates that for every overdose from prescription painkiller, there are:

•    10 treatment admissions for abuse, 32 emergency department visits for misuse or abuse
•    130 people who abuse or are dependent on the drugs
•    825 people who take prescription painkillers for non-medical abuse.


While the death tool is troubling, the number of abusers is hitting unprecedented numbers and our country's opioid addiction is only getting worse.

3. Some groups of people are more susceptible to opiate addiction. Low-income people are prescribed opiates at twice the rate of non-Medicaid patients. Another common practice is those individuals engaging in "physician shopping" — obtaining prescriptions from many different providers.


4. Treating pain costs the United States more than a half-trillion dollars each year. Approximately 100 million Americans suffer from pain, according to the Institute of Medicine Report on Pain. Additionally, the non-medical use of opioid pain reliever can cost insurance companies up to $72.5 billion each year in healthcare costs.


5. Orthopedic surgeons are the third-highest prescribers of opioid prescriptions in the United States according to an article published in the American Academy of Orthopaedic Surgeons, ranking them behind primary care physicians and internists. The primary reason orthopedic physicians prescribe so frequently is due to the pain associated with orthopedic injuries such as broken bones. Treatment such as casting or surgery is typically accompanied with opioid pain medicine during the initial recovery period.

6. Physicians play a vital role in reducing opioid abuse in the United States. Those at highest risk of overdose are as likely to obtain the opioids from a physician's prescription as for free from a friend or relative, according to CDC researchers. Healthcare providers are combating this problem by screening for abuse as well as checking past records in state prescription drug monitoring programs before prescribing.


A great deal of deaths due to opioid overdose can be prevented if healthcare practices take necessary measures. Several common practices such as prescribing too high doses, too fast opioid titration, ignorance about urine drug testing, not updating knowledge of drug interaction and insufficient patient monitoring can lead to more deaths.


7.  Approximately 90 percent of people who experience chronic pain are prescribed opioids, although studies show that opioids only work well to alleviate short-term pain. In a 2010 study of more than 1,000 people suffering chronic pain, the majority of participants taking opioids stated they still suffered moderate to severe pain. Other medications including acetaminophen, ibuprofen or naproxen as well as other non-drug measures often are more successful in alleviating pain than opioids.


8. The rate of painkiller prescriptions also varies based on geographic location. The Northeast, notably Maine and New Hampshire, had the most prescriptions per person for long-acting/extended-release painkillers and for high-dose painkillers. Alabama, Tennessee and West Virginia lead the nation in painkiller prescriptions with 10 of the highest prescribing states located in the South.


State policies also have a profound impact on the number of overdose deaths. The death rate from opioid overdoses in Florida decreased by 23 percent between 2010 and 2012 after state legislators and law enforcement enforced stricter policies on the availability of narcotic painkillers.

9. Opioids are often considered a gateway to other drugs including heroin. Almost half of young individuals who inject heroin reported using prescription opioids before beginning to use heroin. In three recent studies, respondents stated heroin was cheaper and easier to obtain than prescription opioids. Prescription pills generally cost $20 to $60, while heroin costs $3 to $6 per bag.


Each year, the United States allocates resources toward combating drugs. Illicit drugs cost the healthcare system in the United States $11 billion in 2014. Despite all the nation's efforts, drug users continue to abuse drugs and some sadly die from overdoses. The number of overdose deaths involving heroin has almost quadrupled, rising 0.7 deaths per 100,000 Americans in 2000 to 2.7 deaths per 100,000 Americans in 2013. Between 2010 and 2013, the United States saw a 37 percent per year increase in heroin- related deaths. Presently, white indiviudals between 18 to 44 years of age have the highest death rate from heroin abuse.


10. Approximately 4.4 million teenagers in the United States reported taking prescription pain killers, with the average age for first-time users being 13 to 14 years old.  Each day, 2,500 youths aged 12 to 17 years old abuse a prescription pain reliever for the first time. A study found 3.3 percent of 12 to 17 year olds and 6 percent of 17- to 25-year-olds had abused prescription drugs in the past month.

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