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Opioid abuse epidemic

January 29, 2016

Many physicians are concerned about the current epidemic of dependence, abuse, and deaths that have occurred over the past two decades with the concomitant rapid increase in opioid prescriptions. The United States now ranks number two in the world for opioid use per capita.1, 2 A recent study in JAMA Internal Medicine showed that in veterans with chronic non-cancer pain, use of long-acting opioids was associated with unintentional overdose events compared with short-acting opioids, especially in the first 14 days of use.

In a statement published on Friday, December 18, 2015, the Centers for Disease Control and Prevention (CDC) provided the following statistics:

  • U.S. deaths from drug overdoses hit a record high in 2014, propelled by abuse of prescription painkillers and heroin.
  • Drug overdoses increased 6.5 percent in 2014 from a year earlier, killing 47,055 people.
  • Deaths from opioids such as prescription pain killers and heroin accounted for 61 percent of overdose deaths and increased 14 percent in 2014.
  • Deaths from prescription painkillers have been increasing for 15 years and there has been a recent surge in heroin-related deaths, tripling in the last four years.
  • Lower heroin prices, wider availability, and higher purity are causing more overdoses.

In addition, because of the lack of high-quality randomized trials, some experts feel that starting opioid therapy in chronic non-cancer pain with long-acting agents should be completely avoided. Current evidence also supports avoiding long-acting agents altogether, not co-prescribing other sedating drugs, keeping morphine-equivalent doses 3

The CDC recommends stricter guidelines for prescribing pain killers, including the expanded availability of and wider access to naloxone, an antidote for opioid-related overdoses.

Please be aware of these statistics and the CDC?s recommendations when prescribing opioids to your patients. Read the CDC?s press release in its entirety here.

1Dhalla IA et al. Prescribing of opioid analgesics and related mortality before and after the introduction of long-acting oxycodone. CMAJ. 2009;181:891-6

2Bohnert AS et al. Association between opioid prescribing patterns and opioid overdose-related deaths JAMA. 2011:305:1315-21

3Chou R et al. The effectiveness and risks of long-term opioid therapy for chronic pain: A systematic review for a National Institutes of Health Pathways to Prevention Workshop. Ann Intern Med. 2015:162:276-86


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