CDC: US is biggest Rx opioid market

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CDC: US is biggest Rx opioid market
CDC: US is biggest Rx opioid market (credit: PhotoDisc)

HCPs prescribed enough opioid painkiller prescriptions in 2012 to give every American adult a full bottle, the Centers for Disease Control reported Tuesday.

This stat—which amounts to 259 million painkiller prescriptions—was part of an overall opioid report that discussed regional differences and control efforts that appear to have helped states dial back the number of prescription opioid-related deaths. Among the CDC's findings: the majority of the high-prescribing states were in the south, with Alabama, Tennessee and West Virginia having the region's highest number of per-person painkiller prescriptions, while Northeastern states Maine and Vermont had the most per-person prescriptions for extended-release and high-dose painkillers.

The CDC also noted that the US patients “consume opioid pain relievers at a greater rate than any other nation.”

Painkiller use and abuse have become a nationwide health hazard, and like other studies, the CDC's report shows that there is no one clear solution to resolving the mass of pain prescriptions that are flowing into patients' hands. One reason noted in an earlier McGill University study was that the types of pain for which these narcotics are being prescribed has changed—no longer reserved for cancer-related pain, these drugs have been increasingly used for chronic pain. McGill's researchers noted in June that opioid prescriptions for chronic pain doubled between 1980 and 2000, a pattern that dovetailed with new guidance from advocacy groups like the American Academy of Pain Medication and the American Pain Society which have encouraged physicians to consider a wider swath of prescription-eligible patients.

Pill mills and high-prescribing doctors are a concern, and the Centers for Disease Control's report notes that Florida's legal and regulatory crackdowns have helped drive down the number of painkiller-related deaths and reduced the number of high-prescribing doctors. Among the Sunshine State's measures: preventing doctors from dispensing schedule I and schedule II drugs at their offices and requiring pain clinics to register with the state. These efforts, among others, are considered to be major contributors to the decline in opioid-related deaths and a drop in prescriptions between 2010 and 2012. However, heroin-, hydromorphone- and morphine-related deaths rose during this period, a trend the CDC notes “might be a sign of a switch to use of alternative opioids.”

New York and Tennessee have also seen opioid prescriptions drop. Both require prescribers to check state drug monitoring databases before writing opioid pain prescriptions. The centralized data clamps down on doctor shopping because physicians can see when the patient last had a prescription written. The CDC associates a 75% drop in New York patients seeing multiple prescribers since the state fired up its database in 2012. Tennessee saw a 36% drop since its database effort launched two years ago.

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