Our Medical Director, Richard Margolis MD, helps us make sense of new information in psychiatry, addiction, and behavioral health. This blog post is a follow up to last week’s post on the Surgeon General’s Report on Alcohol, Drugs, and Health.
This article includes information from reports by the Washington Post-Kaiser Family Foundation, the Center for Disease Control and Prevention (CDC) and the Substance Abuse and Mental Health Services Administration (SAMHSA). The article highlights how addicting prescription medications are, the rise in deaths attributable to opioids, including prescription pain relievers, and demographic information on vulnerable populations including Medicaid recipients and women.
A Washington Post-Kaiser Family Foundation survey published in the Washington Post’s December 9 Health & Science section reported that, “One-third of Americans who have taken prescription opioids for at least two months say they became addicted to, or physically dependent on, the powerful painkillers.”
The article added that “Virtually all long-term users surveyed said that they were introduced to the drugs by a doctor’s prescription, not by friends or through illicit means. But more than 6 in 10 said doctors offered no advice on how or when to stop taking the drugs. And 1 in 5 said doctors provided insufficient information about the risk of side effects, including addiction.”
The Center for Disease Control and Prevention (CDC) reported in March 2016, “More people died from drug overdoses in 2014 than in any year on record. The majority of drug overdose deaths (more than six out of ten) involve an opioid. And since 1999, the number of overdose deaths involving opioids (including prescription opioid pain relievers and heroin) nearly quadrupled. From 2000 to 2014 nearly half a million people died from drug overdoses. 78 Americans die every day from an opioid overdose.”
The CDC report added “We now know that overdoses from prescription opioid pain relievers are a driving factor in the 15-year increase in opioid overdose deaths. Since 1999, the amount of prescription opioids sold in the U.S. nearly quadrupled, yet there has not been an overall change in the amount of pain that Americans report. Deaths from prescription opioids—drugs like oxycodone, hydrocodone, and methadone—have also quadrupled since 1999.”
The Substance Abuse and Mental Health Services Administration (SAMHSA) published in August 2016, A Collaborative Approach to the Treatment of Pregnant Women with Opioid Use Disorders: Practice and Policy Considerations for Child Welfare and Collaborating Service Providers.
The section titled Opioid Use Trends reported “Opioid use and related consequences also vary by several key demographics. For example, the Medicaid patient population is more likely to receive prescriptions for opioid pain medications and to have opioids prescribed at higher doses and for longer periods of time than the non-Medicaid patient population. Opioid medication overdose deaths are also more common among Medicaid-eligible populations.”
The demographic section described the increase in opioid use among women. “The overall rate of first time heroin use increased among all women, from 0.06 percent in 2002–2004 to 0.10 percent in 2009–2011, estimated to be an increase from 43,000 women to 77,000 women (SAMHSA, 2013). Among women, the number of overdose deaths due to the use of prescription opioid pain medications has increased significantly since 2007, surpassing deaths from motor vehicle-related injuries. Overdose deaths due to opioid medication increased among women more than 5-fold between 1999 and 2010, totaling 47,935 during that period (CDC, 2013).”
There has been a similar increase in opioid use among pregnant women leading to a rise in the Neonatal Abstinence Syndrome. This syndrome and its consequences will be addressed in a future article.