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CDC Report: Fatal Overdoses From Narcotic Painkillers Have Tripled in U.S.

Prescriptions for chronic conditions fuel epidemic, expert says

The epidemic of prescription-painkiller abuse continues to take a deadly toll in the U.S., with fatal overdoses involving drugs such as OxyContin (oxycodone, Purdue Pharma) and Vicodin (hydrocodone bitartrate/acetaminophen, AbbVie) tripling during the decade between 1999 and 2012, according to a new report from the Centers for Disease Control and Prevention (CDC).

Deaths from another form of opiate, heroin, also nearly tripled between 1999 and 2012, according to the report, released December 2.

There was one glimmer of hope, however: In the last year of the study (2011–2012), the CDC noted a 5% drop in deaths from prescription painkillers, the first such decline ever.

The numbers echo similar findings released by the CDC in September. That report covered the years 1999 to 2011, and found steady year-by-year increases in overdose deaths linked to narcotic painkillers. However, there was one sign of hope in that study, too.

“Although the rate [of fatal overdoses] is still increasing, it is not increasing quite as fast as it did between 2000 and 2006,” said co-author Dr. Holly Hedegaard, a CDC epidemiologist. “From 1999 to 2006, the rate of deaths increased about 18% per year, but since 2006 it’s only increasing about 3% per year.”

In the new report, researchers tracked data from the CDC’s National Vital Statistics System. They found that, after adjusting for age, fatal overdoses involving prescription narcotic painkillers more than tripled, from 1.4 cases per 100,000 people in 1999 to 5.1 cases per 100,000 people in 2012.

Kentucky, Nevada, New Mexico, Utah, and West Virginia were hardest hit. In West Virginia, 32 out of every 100,000 residents experienced an overdose of some kind of drug — the highest rate in the nation, the CDC said.

However, the rate of increase for such deaths has slowed nationwide. From 1999 through 2006, there was “an average increase of about 18% each year,” the authors said, but that has slowed since 2006.

Moreover, the 5% decline in narcotic-painkiller deaths observed in 2011–2012 “is the first decrease seen in more than a decade,” the CDC said.

Although it’s difficult to say why that slight decline may have occurred, health officials have moved to curb the spread of narcotic-painkiller abuse. Certain forms of these drugs — such as hydrocodone — have become harder to get because of recent regulatory changes by the FDA.

The FDA has also approved “abuse-deterrent” forms of prescription painkiller pills that are difficult to crush or dissolve, inhibiting users from snorting or injecting them.

But it’s not just opiate-based painkillers that are the problem, the CDC noted. The rates of overdoses from an old foe –– heroin –– are also on the rise in the U.S.

The new report found that “drug-poisoning deaths involving heroin nearly tripled, from 0.7 deaths per 100,000 in 1999 to 1.9 in 2012.” And unlike the trend for prescription painkillers, the upsurge in heroin-related deaths shows no signs of slowing down. In fact, “between 2011 and 2012, the rate of drug-poisoning deaths involving heroin increased 35 percent,” the authors reported.

“We have to stop creating new cases of addiction,” said Dr. Andrew Kolodny, chief medical officer at the Phoenix House Foundation in New York City. “That boils down to getting the medical community to prescribe more cautiously.”

“It's not that doctors are intentionally causing an epidemic, but they are overprescribing painkillers, particularly for common chronic problems like lower-back pain and headaches,” he added.

Kolodny said these painkillers are intended for use in the days following surgery or an accident, or as palliative care for cancer patients. The bulk of the prescribing, however, is for chronic conditions. “That’s what’s really fueling the epidemic,” he said.

Sources: Medical Xpress; December 2, 2014; and CDC; December 2014.

 

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