U.S. nonmedical use of prescription opioid drops but overdose cases rise

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A recent study finds that during the last 12 years the number of nonmedical use of prescription opioids dropped among adults in the U.S., while the prevalence of prescription opioid use disorders, frequency of use, and related deaths increased. The findings of the study are published in the October 13 issue of JAMA.

The United States has experienced increases in illness and death associated with nonmedical use of prescription opioids, since 1999, being referred to as U.S. epidemic. During this period, emergency department visits and drug overdose deaths involving these drugs have increased rapidly.

To completely understand the present status of the epidemic and who is currently most affected, an examination of nationally representative U.S. surveillance data is needed.

Beth Han, M.D., Ph.D., M.P.H., of the Substance Abuse and Mental Health Services Administration, Rockville, Md., and colleagues examined the prevalence of nonmedical use and use disorders and related risk factors with data from 472,200 persons who participated in the 2003-2013 National Surveys on Drug Use and Health.

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. Death rate was based on the 2003-2013 National Vital Statistics System’s Multiple Cause of Death Files.

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. It was observed that death rate 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.

“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,” the authors write.

 

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