Statistics

Drug overdose deaths have increased by 300% since 1999.  Opioid pain medications were the cause of 14,800 deaths in 2008 alone; more than deaths caused by cocaine and heroin abuse combined.  This number has surpassed motor vehicle accidents as the leading cause of accidental death in the United States.

In 2009, opioid misuse/abuse led to more than 475,000 emergency room visits.  This number has since doubled in recent history.

Currently, it has been reported that 100 people die from drug overdoses in the US every day.  More specifically, it is reported that there are approximately 10 overdose deaths a day just in the state of Pennsylvania.

In this country, people consume more opioid pain medication gram for gram, than any other country in the world.  In fact, estimates have been made that in 1999, 11.5 tons of oxycodone was produced worldwide.  Since that time, global pharmaceutical companies have produced more than 75 tons of oxycodone per year, of which 80% of those 75 tons are consumed in the United States!

Opioid Epidemic Origin

After reviewing these devastating numbers, it is easy to appreciate why this is an epidemic in the US.   It is important to understand the origins of this topic in order to create a successful solution to the problem.

The opioid epidemic did not happen overnight.  Over the past 20 years, there have been multiple factors that have contributed to the issue.  One being the idea that pain was undertreated in the past.  National accreditation groups responsible for evaluating health care facilities and providers to ensure the best patient care and safety had developed the idea in 2001 that pain should be addressed in every patient.  This led to the idea that pain is “the fifth vital sign.”  The issue with this is that pain is a symptom, not a vital sign.  Vital signs can be measured objectively and treated accordingly.  Pain is very subjective and varies patient to patient.  As this idea grew and physicians were being encouraged to evaluate and treat pain more readily, the prescribing of narcotics was also growing in number.  This arose right around the same time as long-acting opioids such as Oxycontin came out on the market.

Another factor is that in this time period, laws governing the prescribing of opioids for treatment of chronic, non-cancer pain became less strict which led to increases in opioid consumption.  A campaign was initiated that encouraged better treatment of chronic pain, which certainly is important.  However, this was based mainly on professional opinion at the time, subjective observation, and aggressive marketing by pharmaceutical companies, among other things.  Therefore opioids were used in increasing amounts for the treatment of chronic, non-cancer type pain.  Due to the fact that these medications are legal and in certain cases recommended as a viable treatment option, the general assumption would be to believe these drugs are safe and devoid of any negative side effects or risks.  That can be the case in certain situations in combination with other therapies and for certain diagnoses, but it is still important to recognize the potential for abuse or misuse associated with them.

Today, new laws are being enacted to prevent the over-prescribing of opioid medications.  Health care providers are being held accountable by state regulations in order to adhere to the safe and effective uses of these types of medications.  One way to do that is with a Prescription Drug Monitoring Program (PDMP).

Prescription Drug Monitoring Program

The state of Pennsylvania has recently adopted the use of a PDMP.  This is a state-run electronic database used to track the prescribing and dispensing of opioid pain medications. This information also helps health care providers safely prescribe, identify potential high-risk patients who could benefit from other treatment options, and help patients get the appropriate treatment they need.  Patients also have the right to periodically review and correct the information collected by the PDMP.

While this has newly been enacted in Pennsylvania, other states have had successes with using a PDMP.  In years following the mandating use of a PDMP, states have seen decreases in opioid pain medication overdoses and reductions in patients going to multiple providers for the same prescriptions.

For more information about the Pennsylvania PDMP, visit www.doh.pa.gov/PDMP.

References:

Kristina Fiore Kristina Fiore. “Opioid Crisis: Scrap Pain as 5th Vital Sign?” Medpage Today. MedpageToday, 13 Apr. 2016. Web. 16 Mar. 2017.

Manchikanti, Laxmaiah, MD. “Opioid Epidemic in the United States.” Pain Physician Journal. Pain Physician, 1 July 2012. Web. 5 Mar. 2017.

“Prescription Drug Monitoring Programs (PDMPs).” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 23 Mar. 2016. Web. 16 Mar. 2017.