16 Oct Prescription Opioid Overdose Deaths Increase 35%
MedicalResearch.com Interview with:
Beth Han, MD, PhD, MPH
Substance Abuse and Mental Health Services Administration
U.S. Department of Health and Human Services
Medical Research: What is the background for this study? What are the main findings?
Dr. Han: Since 1999, the United States has experienced increases in negative consequences and deaths associated with nonmedical use of prescription opioids. During this period, emergency department visits and drug overdose deaths involving these drugs have increased rapidly. To fully understand the current status of this public health crisis and who is currently most affected, we conducted this study based on nationally representative U.S. surveillance data.
Our main study findings include:
- Among adults age 18 through 64 years, the prevalence of nonmedical use of prescription opioids decreased from 5.4 percent in 2003 to 4.9 percent in 2013, but the prevalence of prescription opioid use disorders increased from 0.6 percent in 2003 to 0.9 percent in 2013. The 12-month prevalence of high-frequency use (200 days or more) also increased from 0.3 percent in 2003 to 0.4 percent in 2013.
- Mortality assessed by drug overdose death rates involving prescription opioids increased from 4.5 per 100,000 in 2003 to 7.8 per 100,000 in 2013. The average number of days of nonmedical use of prescription opioids increased from 2.1 in 2003 to 2.6 in 2013. The prevalence of having prescription opioid use disorders among nonmedical users increased to 15.7 percent in 2010, 16.1 percent in 2011, 17 percent in 2012, and 16.9 percent in 2013, from 12.7 percent in 2003.
Medical Research: What should clinicians and patients take away from your report?
Dr. Han: Our results can be incorporated into clinician training programs to facilitate effective identification and interventions for high-risk nonmedical users of prescription opioids. Moreover, clinicians can use prescription drug monitoring programs to identify patterns of inappropriate receipt of prescription opioids and screen and treat patients with prescription opioid use disorders as well as other associated specific substance use disorders, nicotine dependence, and depression.
Most adults with prescription opioid use disorders or other substance use disorders neither receive treatment nor do they perceive a need for treatment. Receiving treatment for substance use disorders is particularly critical. SAMHSA is addressing this problem in a number of ways including supporting a variety of prevention and treatment programs, including medically assisted treatments. SAMHSA has also developed an Opioid Overdose Prevention Toolkit that provides guidance on reducing the risk of death from opioid-related overdose. It offers ways that medical providers, people who use opioids nonmedically, and others can recognize the signs of an overdose and effectively reverse it with naloxone.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Han: We found a significant decrease in the percentage of nonmedical use of prescription opioids, as well as significant increases in the prevalence of prescription opioid use disorders, high-frequency use, and related mortality among adults aged 18 through 64 years in the United States over the past decade. Furthermore, the increases identified in this study occurred in the context of increasing heroin use and heroin-related overdose deaths in the United States, supporting a need to address nonmedical use of prescription opioid and heroin abuse in a coordinated and comprehensive manner. Future research should focus on identifying policy and practice interventions to reduce opioid nonmedical use and related morbidity and mortality.
Han B, Compton WM, Jones CM, Cai R. Nonmedical Prescription Opioid Use and Use Disorders Among Adults Aged 18 Through 64 Years in the United States, 2003-2013.JAMA. 2015;314(14):1468-1478. doi:10.1001/jama.2015.11859.
Beth Han, MD, PhD, MPH (2015). Prescription Opioid Overdose Deaths Increase 35%