We talk a lot about the prevalence of illegal drug abuse, addiction, morbidity, and mortality in the Untied States. Drug abuse and addiction of prescription drugs only receive a fraction of the attention that illegal drugs do. However, the CDC’s June 18th "Morbidity and Mortality Weekly Report" (MMWR) might give us cause to pay more attention to the non-medical use of prescription medications.
The CDC relied on a fairly new system called, DAWN. DAWN is a public health info system that records the impact of drug use, misuse, and abuse in the America. It monitors drug-related hospital visits. The patients that DAWN records are medically documented as : taken higher than prescribed amounts of prescription and over the counter drugs (OTC), taken someone else’s prescription drugs, drug-facilitated assault, misuse or abuse of OTC or prescription drugs, drug induced suicide/attempted suicide, seeking detoxification, etc..
According to the study, the rate of prescription drug overdose deaths rose rapidly between 1999 and 2006, with a substantial increase between 2004 and 2008.
The CDC and the Substance Abuse and Mental Health Services Administration (SAMHSA) reviewed emergency room data related to non-medical use of prescription drugs from 2004–2008 . The results showed that ER visits for non-medical use of opioid analgesics increased 111% during those years, with the highest numbers being related to oxycodone, hydrocodone, and methadone overdose/side effects. ER visits involving non-medical use of benzodiazepines increased 89% during th time period.
In Maine, Maryland, New Hampshire, New Mexico, Utah, and Vermont benzodiazepines deaths during 2004- 2007 increased 64.2%, and opioid analgesics deaths increased 47.4%.
The number of ER visits involving non-medical use of prescription or OTC drugs matched the number of ER visits involving illicit drugs in 2008. It is astounding that the number of people seeking medical care from the abuse and misuse of prescription and OTC drugs has reached the same prevalence as illegal drugs.
The increase in number and death was theoretically attributed to factors such as, substantial increases in the prescribing of these classes of drugs. For example, the benzodiazepine, alprazolam had the highest number of ER visits. It was also the most prescribed benzodiazepine in 2008, with over 44 million prescriptions written.
I am a nurse, and I have seen first hand the abuse and misuse of legal drugs. However, these numbers startled me. The current measures (patient education, provider education, and restriction of multiple formulations) to prevent the abuse and misuse of legal drugs are obviously not suffice. The study conclusion calls for “more systematic provider education, universal use of state prescription drug monitoring programs by providers, the routine monitoring of insurance claims information for signs of inappropriate use, and efforts by providers and insurers to intervene when patients use drugs inappropriately.” I could not agree more. This is just as much a societal burden as illegal drugs. In fact, it might be more of a burden when we consider that the tax payer is helping to fund many of these abuses via Medicaid and Medicare.