Emergency department visits for nonmedical use of prescription narcotics has increased 111%

according to the Center for Disease Control (CDC), and Substance Abuse and Mental Health Service Administration’s (SAMHSA) Drug Abuse Warning Network (DAWN) in a report released June 18, 2010.

“DAWN is a public health information system that tracks the impact of drug use, misuse, and abuse in the United States by monitoring drug-related hospital ED visits,” and estimated that “…1.6 million ED visits for the misuse and abuse of all drugs in 2004 and 2.0 million in 2008″ occurred, the CDC stated.

DAWN Report

The report showed the estimated number of ED visits for nonmedical use of opioid analgesics increased from 144,600 to 305,900 visits, and increased 29% during 2007–2008.

“The highest numbers of ED visits were for oxycodone, hydrocodone, and methadone, all of which showed statistically significant increases during the 5-year period. The estimated number of ED visits involving nonmedical use of benzodiazepines increased 89% during 2004–2008 (from 143,500 to 271,700 visits) and 24% during 2007-2008.” according to the CDC.

Prescription drugs have been on a killing spree, with opiates and benzos as the particular drugs responsible, and it is not getting any better. In fact, you have to wonder about the prescribing practices of many physicians, and Big Pharma pounding on physician’s doors to push these drugs on to pharmacies.

Trends and Patterns of Drug Use

CDC Morbidity and Mortality Weekly Report 2010

Prescription Drug Trends

According to the Kaiser Family Foundation, (KFF), spending in the U.S. for legal prescription drugs was $234.1 billion in 2008. That is almost 6 times the amount spent in 1990. “The number of prescriptions dispensed in the U.S. in 2009 increased 2.1 percent (from 3.8 to 3.9 billion),” stated KFF.

Of course, most of these prescriptions were used for legitimate purposes. However, you can bet that many were diverted for illicit use, and prescribed by pill mills.

“The relative magnitudes of the rates shown generally reflect prescription volumes. For example, the benzodiazepine with the highest number of ED visits, alprazolam, was the most prescribed benzodiazepine in the United States in 2008, with an estimated 44 million prescriptions. However, some exceptions exist: hydrocodone was prescribed nearly 124 million times and oxycodone nearly 45 million times in 2008, but hydrocodone ED rates were not higher than oxycodone ED rates. The high frequency of multidrug involvement is a reflection of the tendency of persons who abuse drugs to combine them to moderate or enhance their effects. The lower proportion of single-drug ED visits among benzodiazepine ED visits compared with opioid analgesic visits is consistent with the relative rarity of a benzodiazepine being the sole drug involved in a fatal overdose.” (See DAWN, and Hall AJ, Logan JE, Toblin RL, et al. Patterns of abuse among unintentional pharmaceutical overdose fatalities. JAMA 2008;300:2613–20)

The increases in the nonmedical use of prescription drugs is a testament to the inadequate prevention measures, patient education, drug education efforts in both the schools, and at home, as well as effective drug treatment methods that have a significant impact on relapse rates.

Also needed are universal state prescription drug monitoring programs that can track insurance claims information for signs of inappropriate use of these drugs by patients as the CDC mentioned.

Unfortunately, the relapse rates for opiate addiction are extremely high, and benzos are right behind them. These two drugs are often taken together, and continue to cause both overdoses as well as deaths.

The time has come to divert substantial amounts of money away from the lost “war on drugs” to prevention, intervention, drug education, and treatment.

Miller said the latest annual tally, which concluded on June 30, showed the state nursing board fielded 584 complaints. Of those, more than 100 dealt with substance abuse issues that impaired or caused concern with a nurse’s ability at their job.

McNamara said the American Nurses Association estimates between 6 to 8 percent of nurses use either alcohol or drugs to such an extent to impair their professional judgment.

“Drug issues are not the sole purvey of nurses,” Miller said “We have issues about drug abuse in other health care professions.”

There are no set parameters on if a case is or needs to be reported to the regulatory board. Miller said the agency is at the mercy of receiving that information from hospitals and law enforcement agencies.

“We are not all-knowing and all-seeing,” Miller said. “There are gray areas on what must be reported.”

The risk of drug abuse in medical professionals could be mitigated by instituting random drug testing, said hospital security expert Phil Nielsen. Nielsen is vice president of HSS — a security company that provides services for almost every medical center and hospital in Colorado.

“Drug tests are a great way to prevent theft,” Nielsen said. “It would be a great service to the community. Most of the thefts are like shoplifting in a grocery store.”

Miller said the state board of nursing has no authority to require or enforce drug testing. McNamara said there has been legal precedence in upholding the right for agencies or states to enforce drug testing for certain sensitive medical professions. So why isn’t it done?

via Nurses Abuse Prescription Drugs At Higher Rate – Denver News Story – KMGH Denver.

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US/MountainWyoming Rx Drug Deaths Doubled In Past 4 Years

MATT JOYCE, Associated Press Writer

CHEYENNE, Wyo. AP ― Deaths in Wyoming linked to prescription drug abuse more than doubled from 2005 to 2008, according to statistics released Tuesday by the Wyoming Department of Health.

The deaths include cases where drugs were either a primary or secondary cause of death.

Prescription drug deaths are outpacing those caused by heroin or cocaine.

“These statistics certainly demonstrate an alarming increase in prescription medication-related deaths and should be an eye opener for many Wyoming residents,” said Rodger McDaniel, the department’s deputy director for mental health and substance abuse services.

Meanwhile, the Division of Criminal Investigation said Tuesday that it has seen a 400 percent increase in investigations into illegal prescription drug activity during the last four years.

“Typically we’re involved with the methamphetamine, cocaine, heroin,
marijuana type of investigations, but we have seen in the past couple
of years the large increase in demand to focus our attention on
prescription drugs.”

Zbused prescription drugs include the pain relievers OxyContin,
Hydrocodone and Vicodin; depressants like Valium and Xanax; and
stimulants such as Ritalin and Adderall.

US/MountainWyoming Rx Drug Deaths Doubled In Past 4 Years

MATT JOYCE, Associated Press Writer

CHEYENNE, Wyo. AP ― Deaths in Wyoming linked to prescription drug abuse more than doubled from 2005 to 2008, according to statistics released Tuesday by the Wyoming Department of Health.

The deaths include cases where drugs were either a primary or secondary cause of death.

Prescription drug deaths are outpacing those caused by heroin or cocaine.

“These statistics certainly demonstrate an alarming increase in prescription medication-related deaths and should be an eye opener for many Wyoming residents,” said Rodger McDaniel, the department’s deputy director for mental health and substance abuse services.

Meanwhile, the Division of Criminal Investigation said Tuesday that it has seen a 400 percent increase in investigations into illegal prescription drug activity during the last four years.

“Typically we’re involved with the methamphetamine, cocaine, heroin, marijuana type of investigations, but we have seen in the past couple of years the large increase in demand to focus our attention on prescription drugs.”

Zbused prescription drugs include the pain relievers OxyContin, Hydrocodone and Vicodin; depressants like Valium and Xanax; and stimulants such as Ritalin and Adderall.

DARE infective vs. random oral fluid-based drug screening?

Grapevine-Colleyville is the latest North Texas school district to drop out of the Drug Abuse Resistance Education (DARE) program, and if its exit is any indication, the pioneering anti-drug abuse program for students is not as popular as it once was in the region.

The district elected not to renew its junior-high DARE contract for the 2009-10 school year, district spokeswoman Megan Overman said, opting instead to extend its elementary-level Life Skills program into the middle schools.

Other local districts have also dropped the DARE program over the past decade. Nationally, DARE’s critics have said the program is ineffective and even counterproductive by quoting high usage figures that make drugs seem like a route to popularity for at-risk kids who are seeking to fit in. Other critics say that it is difficult to authenticate DARE’s results and that its information has sometimes been inaccurate.

Cities and school districts are also dealing with tighter budgets, and DARE programs can typically cost $500,000 and more for cities the size of Arlington, Garland and Fort Worth. There is also more competition for students’ time with standardized testing and added math and science requirements.

“We quit using DARE four or five years ago,” said Clint Bond, spokesman for the Fort Worth district. “Apparently, trying to get the data on its effectiveness proved to be not worth the effort for the program.”

via School districts moving away from DARE drug-abuse prevention program | Fort Worth | Star-Telegram.com.

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Approximately 6.9 million individuals aged 12 or older were current (past month) nonmedical users of prescription-type psychotherapeutic drugs (opioid pain relievers,1 tranquilizers, sedatives, or stimulants) during 2007, according to the Substance Abuse and Mental Health Services Administration (SAMHSA) 2007 National Survey on Drug Use and Health (NSDUH).

Current nonmedical use of these drugs, collectively referred to as “controlled prescription drugs (CPDs)” (see text box in Overview section) for the purposes of this report, remained relatively stable from 2003 (6.5 million) to 2007 (6.9 million); however, the number of deaths and treatment admissions involving CPDs, particularly prescription opioids, increased significantly.

According to the Centers for Disease Control and Prevention (CDC) National Center for Health Statistics, unintentional overdose deaths involving prescription opioids increased 114 percent from 2001 (3,994) to 2005 (8,541), the most recent nationwide data available. (See Figure 1.)

Further, the number of treatment admissions for prescription opioids as the primary drug of abuse increased 74 percent from 46,115 in 2002 to 80,131 in 2006, the most recent data available, according to the SAMHSA Treatment Episode Data Set (TEDS).

Source: Centers for Disease Control and Prevention.

via Executive Summary – National Prescription Drug Threat Assessment 2009.

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May 31, 2007 4:24 PM

Prescription drug abuse is skyrocketing, partly due to the growing number of “pill mills” where doctors write prescriptions for non-medical reasons. Armen Keteyian goes inside a Houston facility.

via Prescription Drug Abuse Boom – CBS News Video.

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Michael Jackson’s death spotlights a growing problem with prescription drugs.

Posted July 29, 2009

By Jeanna Bryner, LiveScience

News of Michael Jackson’s death and the possible link to prescription drugs is the latest high-profile example of a growing national problem, as misuse of pharmaceuticals has risen at an alarming rate, touching the lives not just of celebrities but of a large number of non-celebrities, including teenagers.

The abuse of certain prescription drugs nearly doubled from 2000 to 2007, according to the U.S. Department of Health and Human Services’ National Survey on Drug Use and Health. Some health officials are calling the rise in the misuse of prescription drugs an epidemic.

A 2005 report by Columbia University’s National Center on Addiction and Substance Abuse (CASA) documented the problem. “This report revealed that our nation is in the throes of a growing epidemic of controlled prescription drug abuse involving opioids like OxyContin and Vicodin, depressants like Valium and Xanax, and stimulants like Ritalin and Adderall,” Joseph A. Califano, Jr. CASA Chairman and President, told the Senate Judiciary Committee in 2007.

Just last year advocacy group Drug Policy Alliance stated, “There is an overdose epidemic across the country.”

In the Jackson case, Dr. Conrad Murray is said to have given the pop star a powerful sedative called propofol through an intravenous drip, which reportedly may have contributed to his death.

Doctors say prescription drugs have a legit factor that illegal drugs don’t. “They are viewed as being FDA-approved and safe. And that is not true,” said Dr. Lewis Nelson of the NYU Langone Medical Center. “There’s a misperception that because it’s a prescription drug it’s okay.”

via Overdose Epidemic: Not Just for Celebrities – US News and World Report.

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By BRIAN SLUPSKI – bslupski@nwherald.com

Diazepam. Nordiazepam. Oxycodone. Amiodipine. Oxazepam. Temazepam. Hydromorphone. Oxymorphone.

The list of drugs seems like it should be the inventory of a pharmacy.

But the list represents the toxicology results of just one of 18 drug overdose deaths in McHenry County so far this year. In the vast majority of the deaths, prescription drugs played a role. Of the 18 deaths, 14 are considered to have been accidental, three were suicides and in one the cause has not been determined.

“A lot of people who get addicted think that because it came from a doctor, it can’t hurt [them],” said Chris Gleason, director of substance abuse services for Family Service & Community Mental Health Center for McHenry County.

The death of Michael Jackson and subsequent investigation of his doctor, Conrad Murray, once again has thrust the topic of prescription drug abuse into national headlines. Although the results of Jackson’s toxicology report still is pending, there have been multiple reports that the pop singer had a prescription drug problem.

The Jackson story stirred public interest, but some who treat drug addiction worry that it is more spectacle than a serious discussion of a real problem. Generally, there are two kinds of people who abuse prescription medications: People who were legitimately prescribed medication and become addicted, and people who are just looking to get high. The latter category often involves young adults and teenagers.

In February 2007, the Office of National Drug Control Policy issued a report that found, “Among young people ages 12-17, prescription drugs have become the second most abused illegal drug, behind marijuana.” The report also found that “there are troubling signs that teens view abusing prescription drugs as safer than illegal drugs and parents are unaware of the problem.”

via Northwest Herald | Prescription 
drug abuse is 
a local problem.

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