Prescription drug abuse has profoundly changed American culture in many ways, according to Bob Stutman, former special agent of 25 years with the US Drug Enforcement Administration, and principal of the Stutman Group, Boca Raton, Fla, a substance abuse consultancy.

Bob Stutman, The Stutman Group.

Bob Stutman, The Stutman Group.

“The addict demographic has changed from significantly male to about 50:50 male and female,” Stutman says.1 “Furthermore, in 2011, the US Centers for Disease Control and Prevention (CDC) reported that drug overdose was the leading cause of death by accident, for the first time surpassing automobiles as the nation’s leading cause of accidental death.”2

Of the approximately 48,000 US drug overdose deaths in 2014, 26,000 were caused by prescription opioids and benzodiazepines, such as Xanax, and the remainder involved heroin.3, 4 “Almost all heroin users started with prescription drugs before they switched to heroin,” Stutman says.

Stutman cites National Highway Safety Administration statistics showing that almost as many who are under the influence of drugs die in automobile accidents as those under the influence of alcohol.5 And a Nobel Prize-winning study found that the life expectancy of middle-aged white Americans is actually lower than in previous generations. A direct result of the combined influences of drugs, alcohol, and obesity, such reduced life expectancy does not apply to any other ethnic groups in the United States or the middle-aged populations of any other country.6

Stutman adds that large numbers of physicians regularly prescribe painkillers to patients without knowledge of or regard for the high level of abuse associate with such drugs. And many patients perceive any drug prescribed by a family physician to be safe.7

As one result among many, the drug of choice for 12- and 13-year-olds is Vicodin.8 “The two most common pains that these drugs are prescribed for in children are sports injuries and wisdom teeth,” Stutman notes. “But after two days, the patient may become physically dependent on the drugs, while their doctor has usually not mentioned that the drugs are addictive.” Stutman cites further evidence of the problem:

  • One in five visits to a family physician in the United States results in a prescription for opioids.9, 10
  • Every month, well over 200,000 patients present in American emergency departments with the primary symptom being an adverse reaction to prescription drugs.11
  • Prescriptions for opioids and benzodiazepines have risen from approximately 30 million in the early 1990s to 260 million in 2015.12

“The country’s being flooded with opioids,” Stutman says, and asks whether the easing of pain these drugs provide is worth the resulting abuse and deaths. According to a joint statement by FDA and CDC, except in the case of cancer, there is no medical evidence that such drugs are effective for long-term pain control.

REFERENCES

  1. Zicker P. Gender differences in prevalence of drug abuse traced to opportunities to use [online]. Rockville, Md: National Institute on Drug Abuse, 2000. Available at: https://archives.drugabuse.gov/NIDA_Notes/NNVol15N4/Prevalence.html. Accessed February 23, 2016.
  1. Warner M, Chen LH, Makuc D, et al. Drug poisoning deaths in the United States, 1980–2008. NCHS Data Brief, no 81. Hyattsville, MD: National Center for Health Statistics, 2011. Available at: http://www.cdc.gov/nchs/data/databriefs/db81.pdf. Accessed February 23, 2016.
  1. Number and age-adjusted rates of drug-poisoning deaths involving opioid analgesics and heroin: United States, 2000–2014 [online]. Atlanta: Centers for Disease Control and Prevention, 2014. Available at: http://www.cdc.gov/nchs/data/health_policy/AADR_drug_poisoning_involving_OA_Heroin_US_2000-2014.pdf. Accessed February 23, 2016.
  1. Overdose death rates [online]. Rockville, Md: National Institute on Drug Abuse, 2015. Available at: http://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates. Accessed February 23, 2016.
  1. Hedlund J. Drug-impaired driving. Washington: Governors Highway Safety Association, 2015. Available at: http://www.ghsa.org/html/files/pubs/GHSA_DruggedDriving2015_R7_LoResInteractive.pdf. Accessed February 23, 2016.
  1. Case A, Deaton A. Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century. PNAS. 2015;112(49):15078–15083; doi: 10.1073/pnas.1518393112.
  1. Leung M. Lack of education given on opioid use, surveyed physicians report. Pain Medicine News. 2015. Available at: http://www.painmedicinenews.com/Multimedia/Article/11-15/Lack-of-Education-Given-on-Opioid-Use-Surveyed-Physicians-Report/34180. Accessed February 23, 2016.
  1. Results from the 2012 National Survey on Drug Use and Health: summary of national findings. NSDUH Series H-46, HHS Publication No. (SMA) 13-4795. Rockville, Md: Substance Abuse and Mental Health Services Administration, 2013. Available at: http://archive.samhsa.gov/data/NSDUH/2012summnatfinddettables/nationalfindings/nsduhresults2012.htm#ch2.1. Accessed February 23, 2016.
  1. Becker WC, Tobin DG, Fiellin DA. Nonmedical use of opioid analgesics obtained directly from physicians: prevalence and correlates. Arch Intern Med. 2011;171(11):1034–1036; doi: 10.1001/archinternmed.2011.217.
  1. Jackson DW. Chronic pain management is more than filling opioid prescriptions and extending disability claims. Orthopedics Today. 2011. Available at: http://www.healio.com/orthopedics/business-of-orthopedics/news/print/orthopedics-today/%7B819e61ae-6a21-4088-832b-331978a938d5%7D/chronic-pain-management-is-more-than-filling-opioid-prescriptions-and-extending-disability-claims. Accessed February 23, 2016.
  1. DrugFacts: drug-related hospital emergency room visits [online]. Rockville, Md: National Institute on Drug Abuse, 2011. Available at: https://www.drugabuse.gov/publications/drugfacts/drug-related-hospital-emergency-room-visits. Accessed February 23, 2016.
  1. Dowell D, Haegerich T, Chou R. CDC guideline for prescribing opioids for chronic pain: United States, 2016 [online]. Waltham, Mass: Massachusetts Medical Society, 2016. Available at: http://www.massmed.org/Advocacy/Key-Issues/Opioid-Abuse/CDC-Draft-Opioid-Prescribing-Guidelines-for-Chronic-Pain—Dec-2015-(pdf)/. Accessed February 23, 2016.