Prescription pain medications bind to receptors in the brain or body to reduce pain. While prescription drugs are certainly useful in many cases, such as for patients with chronic pain, for post-operative care, or to manage pain after an injury, the problem comes when people become addicted to these medications.
The most common drugs used to treat pain include oxycodone, fentanyl, and hydrocodone. Another common opioid is heroin. Other drugs that can be addictive include Valium, Xanax, Adderall, and Ritalin. However, the U.S. Department of Health and Human Services reports that the majority of drug addiction and abuse cases relates to opioid analgesics, or pain medications.
According to statistics from the American Society of Addiction Medicine (ASAM), 52,404 people in the U.S. died from lethal drug overdoses in 2015. Over 20,000 of those deaths were related to prescription pain relievers, while 12,990 of the deaths related to overdose on heroin. The overdose death rate increased by nearly four times between 1999 and 2008, and the number of prescriptions filled for pain relievers quadrupled from 1999 to 2010. In fact, 259 million prescriptions were written for opioids in 2012, which is enough prescriptions to give every adult in America a bottle of pain pills.
As you work toward your masters of public health online, you will find that prescription drug addiction is a significant issue for officials in the US.
Underestimates for Misuse
Data from the Center for Disease Control (CDC) shows that doctors began increasing their prescribing habits for opioid analgesics in the 1990s to help patients treat moderate to severe pain. Many of these physicians didn't know that the medications would become such a problem in the public health industry. Not all physicians adequately stress the risk of prescription drug abuse, so accidental overdoses are common. In the years following the 1990s, prescription painkillers rose above marijuana as the most recreationally used drug by teenagers.
Within the past decade, the main drug involved in overdose deaths also shifted from OxyContin to methadone. Methadone is substantially cheaper than OxyContin, which contributes to its increase in use.
Higher Rates in Certain Areas
Certain areas of the U.S. have been affected more by the epidemic of drug abuse and overdose. The CDC report reveals that states in the South and the Midwest had double the mortality rates due to drug overdose, while the rate in West Virginia increased by 500 percent. The increases in mortality rates tend to be higher in rural parts of the country.
Economic and Social Factors
When studying common factors among those addicted to prescription drugs, CDC officials found that the rates of abuse are higher in low-income populations, and many of these people rely on Medicaid to fund the prescriptions.
A 2016 study showed that U.S. veterans are at a higher risk for drug addiction and overdose. Nearly all the veterans studied had multiple risk factors for overdose. These risk factors include history of arrest or incarceration, alcohol use, history of injection drug use, use of sedatives, history of prior overdose, and use of cocaine.
The data from the ASAM shows that adolescents and young adults are among the highest groups at risk for drug addiction. In 2015, more than a quarter of a million adolescents in the U.S. were currently using pain medications that were not prescribed to them, and 122,000 of those adolescents reported having an addiction.
The number of overdose deaths among women also increased by over 400 percent between 1999 and 2010, while the rate among men in the same time period increased by 237 percent. The ASAM study reported that women are more likely than men to experience chronic pain and receive pain medication at higher doses for use over longer periods of time.
Challenges in Responding to Addiction and Overdose
Prescription drug addiction has become a public health crisis in the U.S., and the number of overdoses has increased as well. However, several challenges make it difficult for local and federal government agencies, health care professionals, and public health officials to combat the growing problem. Some of the biggest hurdles include confidentiality and privacy concerns, insufficient data, and a lack of state-based injury prevention barriers to help reduce the number of people who are prescribed pain medications.
A Public Health Crisis
There are several reasons that the increase in drug addiction and overdose has become a public health crisis. Since many of those addicted to prescription drugs rely on state-funded and federally funded health care programs, tax dollars often fund the prescriptions.
It's also a large-scale problem because the ASAM reports that many of those addicted to prescription pain pills will begin using heroin. The data shows that 80 percent of first-time heroin users started by misusing prescription pain medication. In a survey conducted in 2014 by the ASAM, 94 percent of those questioned reported that they switched to heroin use because prescription pain pills were harder to get and more expensive.
Combating the problems with prescription drug addiction and overdose is one of the challenges faced by public health professionals. Rehab programs are designed to provide physical relief along with mental and emotional support to those who are working to overcome their addictions to prescription drugs. Community outreach programs are also beneficial, especially in areas with higher rates of abuse. Still, their efforts could be improved through the following:
- Collaboration with insurers and benefits managers to review claims and deny coverage when abuse is suspected
- Better coordination of care for patients among federal agencies for better tracking, which could help reduce "doctor shopping"
- More comprehensive public and provider education programs
- Better analytics for tracking and regulating prescription drugs
- Stronger evidence to back prescription drug abuse prevention programs
- New formulations of drugs that can minimize addiction
- Expanded efforts to educate, intervene, and refer patients for treatment
Understanding this public health crisis could be the first step in reducing the number of people who are addicted to prescription drugs and lowering the overdose rate. With a Master of Public Health online degree from the Keck School of Medicine of USC, you can work toward improving programs in your own community.