The dope on Rx painkiller abuse...and use

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In recent years, abuse of prescription painkillers has reached staggering heights, with oxycodone and hydrocodone overdose claiming over 14,000 lives in 2008 alone, according to the Centers for Disease Control and Prevention. Even more alarming still, the toll of these drugs may be rising, as popular opioid pain relievers like OxyContin, Percocet (oxycodone), and Vicodin (hydrocodone) have seen sales increase by as much as sixteen-fold in some states between 2000 and 2010. Public health officials are worried that greater use of these medications is symptomatic of a nationwide addiction epidemic, leading to accidental deaths and violence, including pharmacy robberies.

Recently, these disconcerting figures have prompted government officials to tighten up enforcement of drug sale regulations: 40 states have implemented a prescription drug monitoring program to track patients use. However, while these measures may be a step in the right direction, the programs are not coordinated across state lines; consequently, many abusers get around the system by simply filling prescriptions in other states.

A variety of factors have contributed to the rise in abuse: Doctor shopping, for instance, is common among drug addicts who will go from doctor to doctor seeking new painkiller prescriptions; also problematic are pill mills physicians offices that dispense dozens of prescriptions daily with minimal or no medical evaluation. Affluent suburbs, in particular, have seen a spike in abuse: For instance, New York City s borough of Staten Island saw painkiller drug sales increase by 1,200 percent between 2000 and 2010.

However, while current news stories highlight such unscrupulous practices and abuse, most painkiller use is actually based on real medical need. The large majority of such prescriptions are made out to patients with chronic (or acute) pain who use the drugs legitimately. A larger aging U.S. population that faces a greater incidence of chronic illness may also be contributing to increases in painkiller use.

As ACSH s Dr. Gilbert Ross points out, Many patients need such medications for chronic pain related to cancer, arthritis, or other conditions. He adds, Other patients may only require the drugs for a limited period of time, as is often the case with post-operative recovery or acute trauma. It s important to keep in mind that only a small fraction of those who have prescriptions filled for these painkillers are actually committing fraud by manipulating prescriptions or by doctor shopping.

Though ACSH s Dr. Josh Bloom is aware of the problems with opiate abuse, he believes that it s most important to ensure that those who are suffering from chronic pain have ready access to the appropriate therapies. Management of chronic pain is still quite unsophisticated in modern medicine, says Dr. Bloom. Each class of medication has significant liabilities, so to make it even harder for patients to get the help they need is the absolute wrong thing to do. They should not suffer needlessly because others are abusing these drugs.