Trends in Opioid Analgesic Abuse and Mortality in the United States

Published on Jan 14, 2015in The New England Journal of Medicine74.699
· DOI :10.1056/NEJMSA1406143
Richard C. Dart58
Estimated H-index: 58
(WashU: Washington University in St. Louis),
Hilary L. Surratt48
Estimated H-index: 48
(NSU: Nova Southeastern University)
+ 4 AuthorsJody L. Green24
Estimated H-index: 24
Sources
Abstract
Background The use of prescription opioid medications has increased greatly in the United States during the past two decades; in 2010, there were 16,651 opioid-related deaths. In response, hundreds of federal, state, and local interventions have been implemented. We describe trends in the diversion and abuse of prescription opioid analgesics using data through 2013. Methods We used five programs from the Researched Abuse, Diversion, and AddictionRelated Surveillance (RADARS) System to describe trends between 2002 and 2013 in the diversion and abuse of all products and formulations of six prescription opioid analgesics: oxycodone, hydrocodone, hydromorphone, fentanyl, morphine, and tramadol. The programs gather data from drug-diversion investigators, poison centers, substance-abuse treatment centers, and college students. Results Prescriptions for opioid analgesics increased substantially from 2002 through 2010 in the United States but then decreased slightly from 2011 through 2013. In general, RADARS System programs reported large increases in the rates of opioid diversion and abuse from 2002 to 2010, but then the rates flattened or decreased from 2011 through 2013. The rate of opioid-related deaths rose and fell in a similar pattern. Reported nonmedical use did not change significantly among college students.
Download
📖 Papers frequently viewed together
777 Citations
201645.54JAMA
3 Authors (Deborah Dowell, ..., Roger Chou)
3,153 Citations
699 Citations
References15
Newest
#1James A. InciardiH-Index: 65
#2Hilary L. SurrattH-Index: 48
Last. Theodore J. CiceroH-Index: 55
view all 4 authors...
Generic drugs account for half of all prescription drug purchases in the United States. Although they are bioequivalent to their branded counterparts, they are typically sold at substantial discounts from the branded price. Given this, the purpose of this analysis is to examine the impact of the introduction of generic forms of selected opioids on their diversion to the illicit marketplace. The analgesics in this analysis include oxycodone ER (extended release), and the fentanyl transdermal patc...
9 CitationsSource
#1Richard C. Dart (University of Colorado Denver)H-Index: 58
Last. Edgar H. AdamsH-Index: 17
view all 3 authors...
OBJECTIVES: Prescription opioid analgesics play an important role in managing moderate to severe pain. An unintended consequence of the availability of these drugs is nonmedical use. We report rates and methods of nonmedical use of the analgesic tapentadol immediate release (IR) and other commonly prescribed opioid analgesics among US college students following the launch of tapentadol IR in June 2009. MATERIALS AND METHODS: The Researched Abuse, Diversion and Addiction-Related Surveillance Syst...
17 CitationsSource
#1Sean Esteban McCabe (UM: University of Michigan)H-Index: 74
#2Brady T. West (UM: University of Michigan)H-Index: 51
Last. Carol J. Boyd (UM: University of Michigan)H-Index: 66
view all 4 authors...
Objectives To examine trends in the lifetime and past-year prevalence of medical use, diversion, and nonmedical use of four prescription medication classes (i.e., sedative/anxiety, opioid, sleeping, and stimulant) among college students between 2003 and 2013; and to identify demographic and background characteristics associated with trends in past-year nonmedical use of prescription medications.
203 CitationsSource
#1Hilary L. Surratt (NSU: Nova Southeastern University)H-Index: 48
#2Catherine L. O'Grady (NSU: Nova Southeastern University)H-Index: 8
Last. Minxing Chen (University of Texas Health Science Center at Houston)H-Index: 7
view all 7 authors...
PURPOSE: Florida has been at the center of the nation's ongoing prescription opioid epidemic, with largely unregulated pain clinics and lax prescribing oversight cited as significant contributors to the opioid problem in the state. METHODS: In an effort to mitigate prescription opioid abuse and diversion in Florida, legislative interventions were implemented during 2010 and 2011, which included two primary elements: (i) comprehensive legislation to better regulate the operation of pain clinics; ...
82 CitationsSource
#1Jonathan M. Davis (Hospital Authority)H-Index: 55
#2Stevan G. Severtson (Hospital Authority)H-Index: 11
Last. Richard C. Dart (University of Colorado Denver)H-Index: 58
view all 4 authors...
BACKGROUND: Prescription drug abuse is a critical problem in the USA and has been linked to more deaths than automobile accidents. Despite this growing epidemic, the USA lacks a timely early warning system. Poison centers (PCs) have the potential to act as sentinel reporting entities for prescription drug abuse and misuse due to near-real-time data reporting and abundant coverage in the USA. METHODS: Data from the Researched Abuse, Diversion and Addiction-Related Surveillance (RADARS®) System PC...
30 CitationsSource
#1James B. MowryH-Index: 20
#2Daniel A. SpykerH-Index: 29
Last. Marsha D. FordH-Index: 12
view all 5 authors...
AbstractBackground: This is the 30th Annual Report of the American Association of Poison Control Centers’ (AAPCC) National Poison Data System (NPDS). As of July 1, 2012, 57 of the nation's poison centers (PCs) uploaded case data automatically to NPDS. The upload interval was 7.58 [6.30, 11.22] (median [25%, 75%]) min, creating a near real-time national exposure and information database and surveillance system.Methodology: We analyzed the case data tabulating specific indices from NPDS. The metho...
319 CitationsSource
#1Stevan G. Severtson (Hospital Authority)H-Index: 11
#2Becki Bucher Bartelson (Hospital Authority)H-Index: 15
Last. Richard C. Dart (CU: University of Colorado Boulder)H-Index: 11
view all 9 authors...
Abstract This study evaluated changes in abuse exposures, therapeutic error exposures, and diversion into illegal markets associated with brand extended-release oxycodone (ERO) following introduction of reformulated ERO. Original ERO and reformulated ERO street prices also were compared. Data from the Poison Center and Drug Diversion programs of the Researched Abuse, Diversion and Addiction-Related Surveillance (RADARS) System were used. Quarterly rates 2 years prior to introduction of reformula...
79 CitationsSource
#1George J. Unick (UMB: University of Maryland, Baltimore)H-Index: 15
#2Daniel Rosenblum (Dal: Dalhousie University)H-Index: 10
Last. Daniel Ciccarone (UCSF: University of California, San Francisco)H-Index: 34
view all 4 authors...
The historical patterns of opiate use show that sources and methods of access greatly influence who is at risk. Today, there is evidence that an enormous increase in the availability of prescription opiates is fuelling a rise in addiction nationally, drawing in new initiates to these drugs and changing the geography of opiate overdoses. Recent efforts at supply-based reductions in prescription opiates may reduce harm, but addicted individuals may switch to other opiates such as heroin. In this a...
207 CitationsSource
#1Nabarun Dasgupta (UNC: University of North Carolina at Chapel Hill)H-Index: 26
#2Jonathan M. DavisH-Index: 55
Last. Richard C. Dart (University of Colorado Denver)H-Index: 58
view all 4 authors...
PURPOSE: There are more drug overdose deaths in the Untied States than motor vehicle fatalities. Yet the US vital statistics reporting system is of limited value because the data are delayed by four years. Poison centers report data within an hour of the event, but previous studies suggested a small proportion of poisoning deaths are reported to poison centers (PC). In an era of improved electronic surveillance capabilities, exposure calls to PCs may be an alternate indicator of trends in overdo...
23 CitationsSource
#1Theodore J. CiceroH-Index: 32
#2Matthew S. Ellis (WashU: Washington University in St. Louis)H-Index: 20
Last. Hilary L. Surratt (NSU: Nova Southeastern University)H-Index: 48
view all 3 authors...
In 2010, an abuse-deterrent formulation of the widely abused prescription opioid OxyContin replaced the original formulation. After the new formulation was introduced, patients reported that they used OxyContin less often and other drugs (including heroin) more often.
245 CitationsSource
Cited By817
Newest
#1Samuel J. Rubin (BMC: Boston Medical Center)H-Index: 5
#2Judy Wang (BMC: Boston Medical Center)
Last. Heather A. Edwards (BMC: Boston Medical Center)H-Index: 3
view all 6 authors...
Abstract null null Purpose null Determine whether opioid prescribing patterns have changed as a result of implementation of a prescription drug monitoring program (PDMP) in the state of Massachusetts. null null null Materials and methods null A multicentered retrospective study was performed including patients who received tonsillectomy, parotidectomy, thyroidectomy or direct laryngoscopy and biopsy with or without rigid esophagoscopy and/or rigid bronchoscopy at Lahey Hospital and Medical Cente...
Source
#1Medhat M. Bassiony (Zagazig University)H-Index: 11
#2Ghada M. Salah El-Deen (Zagazig University)H-Index: 3
Last. Rehab S Mahdy (Zagazig University)H-Index: 3
view all 4 authors...
Background and objectives null Many studies investigated the association between attention-deficit/hyperactivity disorder (ADHD) and substance use disorders (SUDs) but none focused on the association between ADHD and nonmedical prescription opioids such as tramadol. The objective of this study was to assess the prevalence, correlates, and consequences of co-occurrence of ADHD and tramadol use among adults. null Methods null This study included 122 Egyptian adults with opioid use disorders attrib...
Source
#1Ryan Howard (UM: University of Michigan)H-Index: 13
#2Jeremy Albright (UM: University of Michigan)H-Index: 7
Last. Peter K. Henke (UM: University of Michigan)H-Index: 69
view all 5 authors...
Abstract null null Objective null Opioid use is common among patients with peripheral arterial disease (PAD), given that pain is a defining symptom. Unfortunately, long-term opioid use places patients at dramatically increased risk of overdose and death. Although surgical revascularization is extremely effective in alleviating ischemic pain related to PAD, it is unclear whether this practice results in the discontinuation of opioids after surgery. Therefore, we conducted the following study to i...
Source
#1Hamed Aramjoo (Birjand University of Medical Sciences)H-Index: 2
Last. Saeed SamarghandianH-Index: 19
view all 6 authors...
This study aimed to assess the effects of Buprenorphine (BUP) on oxidative parameters in pups born to mothers exposed to the drug during gestation and lactation. Pregnant and lactating rats received BUP, 0.5 or 0.1 mg/kg subcutaneously for 21 and 28 days, respectively. At the end of the study, the pups were anesthetized, and the hearts were dissected out to measure oxidative stress indices, including the levels of Malondialdehyde (MDA), Nitric oxide (NO), Glutathione (GSH), and the activity of S...
Source
#1Surya Veerabagu (Tulane University)H-Index: 1
#2Brian Cheng (USC: University of South Carolina)
Last. H. William Higgins (HUP: Hospital of the University of Pennsylvania)H-Index: 2
view all 14 authors...
Importance null To curtail the opioid epidemic, physicians have been advised to limit opioid prescriptions. null Objective null To characterize the frequency and changes over time (2009-2020) of opioid prescriptions following Mohs micrographic surgery. null Design, setting, and participants null This cross-sectional study using Optum Clinformatics DataMart (Optum CDM), a nationally representative insurance claims database, included patients aged 18 years and older who had Mohs micrographic surge...
Source
#1Taneisha Wilson (Brown University)H-Index: 3
#2Shih-Chuan Chou (Brigham and Women's Hospital)H-Index: 6
Last. Francesca L. Beaudoin (Brown University)H-Index: 13
view all 5 authors...
Abstract null null Background null Acute pain from a vaso-occlusive crisis (VOC) is a leading reason patients with sickle cell disease (SCD) visit the emergency department (ED). Prior studies suggest that women and men receive disparate ED treatment for acute pain in EDs. We aim to determine sex differences in analgesic use among patients with SCD presenting to the ED. null null null Methods null This cross-sectional study uses data from the National Hospital Ambulatory Medical Care Survey (NHAM...
Source
#1Doreen BusingyeH-Index: 7
#2Benjamin Daniels (UNSW: University of New South Wales)H-Index: 12
Last. Suzanne BloggH-Index: 1
view all 7 authors...
Little is known about private-market opioid prescribing and how Australian opioid policies impact prescribing across public and private markets in Australia. We aimed to investigate publicly subsidised and private-market opioid prescribing from 2013 to 2018. We used prescribing records from MedicineInsight, an Australian primary care database, to examine trends in prescriptions for non-injectable opioid formulations from October 2013 to September 2018. We examined annual opioid prescribing trend...
Source
#1Stephen C. Dryden (UTHSC: University of Tennessee Health Science Center)H-Index: 1
#2Jonathan E. Rho (UTHSC: University of Tennessee Health Science Center)
Last. Brian T. Fowler (UTHSC: University of Tennessee Health Science Center)H-Index: 4
view all 9 authors...
To assess extended release/long acting (ER/LA) opioid prescribing patterns among ophthalmic plastic surgeons in the Centers for Medicare and Medicaid Services (CMS) Part D database.A retrospective ...
Source
#1Michael DiNardi (URI: University of Rhode Island)H-Index: 1
OBJECTIVE To determine the association between the abuse-deterrent reformulation of OxyContin and adolescent lifetime heroin use in the United States. METHODS The quasi-experimental study uses individual survey data from the 1999-2019 Youth Risk Behavior Surveillance System to examine whether the reformulation of OxyContin in August 2010 affected adolescent lifetime heroin use, exploiting heterogeneity in state-level rates of OxyContin misuse before the reformulation. Multiple regression analysi...
Source
#1Ilunga Kamika (UNISA: University of South Africa)H-Index: 13
#2Shohreh Azizi (UNISA: University of South Africa)H-Index: 5
Last. Thabo T.I. Nkambule (UNISA: University of South Africa)H-Index: 13
view all 7 authors...
Abstract null null The continuous influx of opioid compounds into aquatic environments has become an increasing and persistent concern, due to their extensive use. This is especially alarming as wastewater treatment plants (WWTPs) are unable to completely remove them. Despite the reported health concerns, the occurrence of opioid compounds in the environment has not received much attention. The present study investigates the occurrence of 19 opioids in four WWTPs and their respective receiving w...
Source