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The Opioid Crisis Part 1: More than 175 Americans Are Dying Every Day!

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The opioid crisis has now surpassed the number of people killed in accidents in the US, while 6%  percent of people prescribed narcotics (opioid) become addicted after taking them for one day! This important series will reveal how devastating this epidemic is, and what you can to do protect yourself from becoming its next victim.  We’ll also review Congress’ role in impairing the DEA’s ability to curtail the illegal distribution of these devastating drugs in Part 2, and in part 3 we’ll take a look at what you can do to manage pain. Read more…

Six percent of people prescribed narcotics (opioid) become addicted after taking them for one day! This important series will reveal how devastating this epidemic is, and what you can to do protect yourself from becoming its next victim.  We’ll also explore the role Congress played in handcuffing the DEA limiting their ability to curtail illegal distribution of these devastating drugs in Part 2 of our series, and in part 3 we’ll take a look at what you can do to manage pain.

You’ve heard about recent epidemics, crack, methamphetamine, the resurgence of heroin.  They all pale in comparison to the escalating damage the opioid pandemic has caused and continues to wreak across the United States, and is now poised to visit other nations around the world. 

According to the CDC, and estimated 64,000 people will died in 2016 from an opioid overdose, and the numbers are growing.

Most Commonly Overdosed Opioids

The most common drugs involved in prescription opioid overdose deaths include:

  • Methadone
  • Oxycodone (such as OxyContin®)
  • Hydrocodone (such as Vicodin®)4

Overdose Deaths

Among those who died from prescription opioid overdose between 1999 and 2014:

  • Overdose rates were highest among people aged 25 to 54 years.
  • Overdose rates were higher among non-Hispanic whites and American Indian or Alaskan Natives, compared to non-Hispanic blacks and Hispanics. 
  • Men were more likely to die from overdose, but the mortality gap between men and women is closing.5

Additional Risks

Overdose is not the only risk related to prescription opioids. Misuse, abuse, and opioid use disorder (addiction) are also potential dangers.

  • In 2014, almost 2 million Americans abused or were dependent on prescription opioids.
  • As many as 1 in 4 people who receive prescription opioids long term for noncancer pain in primary care settings struggles with addiction.7
  • Every day, over 1,000 people are treated in emergency departments for misusing prescription opioids.8

 

Study Finds Opioid Supply of Three Days or Less Reduces Likelihood of Chronic Opioid Use

Doctors who limit the supply of opioids they prescribe to three days or less may help patients avoid the dangers of dependence and addiction, a new study suggests.

Among patients without cancer, a single day’s supply of a narcotic painkiller can result in 6 percent of patients being on an opioid a year later, the researchers said.

The odds of long-term opioid use increased most sharply in the first days of therapy, particularly after five days of taking the drugs. The rate of long-term opioid use increased to about 13 percent for patients who first took the drugs for eight days or more, according to the report.

“Awareness among prescribers, pharmacists and persons managing pharmacy benefits that authorization of a second opioid prescription doubles the risk for opioid use one year later might deter overprescribing of opioids,” said senior researcher Martin Bradley. He is from the division of pharmaceutical evaluation and policy at the University of Arkansas for Medical Sciences.

By prescribing for a patient an opioid supply of three days or less, a health care professional can reduce the likelihood of a patient’s chronic opioid use one to three years later, according to University of Arkansas for Medical Sciences (UAMS) research.

In a report published online March 17 in the Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report, UAMS researchers Bradley Martin, Pharm.D., Ph.D., Anuj Shah, a Ph.D. student, and Corey Hayes, Pharm.D., looked at people previously prescribed opioids who had not used one in six months, the number of days on an opioid prescription they received and whether they were still using opioids one and three years later.

The UAMS-funded study used 1.2 million patient records from 2006-2015 that were drawn from the IMS Lifelink+ database, which includes commercial health plan information and insurees. Any identifying information was removed from the records before the researchers analyzed them.

Among the researchers’ findings were that the likelihood of chronic opioid use increases with each additional day of medication supplied, starting on the third day, and increases the sharpest after the sixth and 31st days on opioid therapy or when a second prescription was authorized or refilled.

“A person who receives just an 11-day supply of their first opioid, their probability of them still being a user one year later is 25 percent,” Martin said. “I don’t think clinicians realize how likely that is. There’s a very significant risk that rises quickly in a short period of time.”

Individuals starting on a long-acting opioid such as oxycontin or morphine sulfate, or a commonly prescribed opioid like tramadol, were more likely to remain on opioids than persons prescribed hydrocodone or oxycodone. The data show that prescribing three days or fewer of opioids can reduce the chances of long-term opioid use.

Martin, the senior author of the study, is a professor and head of the Division of Pharmaceutical Evaluation and Policy at the University of Arkansas’ College of Pharmacy. Shah, a co-author with Martin and Hayes, is a Ph.D. student in the division and a fellow at the Arkansas Center for Health Improvement, and Hayes is a postdoctoral fellow in the UAMS College of Medicine’s Department of Psychiatry.

In March 2016, the Centers for Disease Control and Prevention issued a recommendation for prescribing less than a week’s supply of opioids for acute pain and for selecting what type of opioid to prescribe when therapy is started.

“We wanted to corroborate that,” Martin said. “In earlier research, we had looked at how long it takes a chronic user of opioids to discontinue use. Entering into this research, we were wondering at what point does someone becomes a chronic user. No one had looked at when that happens. When does the transition happen between short-term to long-term use?”

Martin said while there is no clear and specific point of transition to chronic use, the longer the duration of periods of even early opioid use can lead to an increased risk of chronic use months or even years later.

30 Million Medical & Pharmacy Records Reviewed

The new report was prepared by Blue Cross Blue Shield, which combed the medical and pharmacy records of 30 million of its members to glean trends in the opiate addiction epidemic. By 2016, BCBS reported, nearly 1 percent of its members had been diagnosed with opioid use disorder.

In addition to providing insight into the extent of the opioid crisis – and the anemic response to treating the afflicted – the insurance giant’s records yielded insights into which patients are most likely to become addicted, and how.

It found that in 2015, roughly one in five privately insured adults in the United States filled at least one prescription for a prescription narcotic painkiller.

Close to half of those patients – 45 percent of those prescribed prescription opioids – received high doses of narcotic painkillers, which were most likely to result in a later diagnosis of addiction disorder.

Pharmacy and medical records showed that the highest rate of addiction disorders was seen in patients who had been prescribed high doses of prescription pain relief medicine for short periods – fewer than 90 days. Fully 6.2 percent of those patients would go on to be diagnosed with an opioid addiction disorder.

Many of those patients got hooked after a physician prescribed a relatively short course of pain medication for appendicitis, osteoarthritis, back or joint pain, or kidney or gallstones.

Right behind them, in terms of addiction risk, were patients who were prescribed high doses of painkillers for more than 90 days, typically for chronic conditions such as arthritis and back pain. Of those patients, 4 percent would eventually be diagnosed with opioid addiction.

Lower doses of opioids, even over a long period, were found to be far less addictive than high doses. But the length of a patient’s treatment with painkillers also escalated the risk of addiction.

2014 Addiction Increase

The Blue Cross Blue Shield report suggests that the spurt in addiction disorder diagnoses that started in 2014 may have been driven in part by growing recognition of opioid addiction among physicians.

But prescribing practices clearly played a key role too. In 2015, the highest density of patients filling prescriptions for opioid narcotics lay in an arc of states spanning Oklahoma, Arkansas, Louisiana, Mississippi and Alabama, with slightly lower rates in Georgia, Tennessee, North and South Carolina, West Virginia and Indiana.

In 2016, physicians in those same states were diagnosing opioid use disorder at extremely high rates.

Blue Cross Blue Shield called opiate addiction “the fifth most impactful condition affecting the health of commercially insured members in the U.S.”

“It will take a collaborative effort of health providers, insurers, communities and all levels of government working together to develop solutions that effectively meet community needs,” the insurance giant said.

Source:

https://medicalxpress.com/news/2017-07-opioid-addiction-skyrockets-treatment-addicts.html

https://www.cdc.gov/drugoverdose/index.html

https://www.cdc.gov/drugoverdose/data/overdose.html

https://www.nytimes.com/interactive/2017/06/05/upshot/opioid-epidemic-drug-overdose-deaths-are-rising-faster-than-ever.html

https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates

http://journals.lww.com/clinicalpain/Abstract/2014/07000/The_Role_of_Opioid_Prescription_in_Incident_Opioid.1.aspx

Martin Bradley, PharmD, Ph.D., division of pharmaceutical evaluation and policy, College of Pharmacy, University of Arkansas for Medical Sciences, Little Rock; Scott Krakower, D.O., assistant unit chief, psychiatry, Zucker Hillside Hospital, Glen Oaks, N.Y.; March 17, 2017, Morbidity and Mortality Weekly Report

https://uamshealth.com/news/2017/03/27/uams-study-finds-opioid-supply-of-three-days-or-less-reduces-likelihood-of-chronic-opioid-use/

 

https://www.webmd.com/mental-health/addiction/news/20170316/opioid-dependence-can-start-in-just-a-few-days#1

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