by Brian Malkin
On November 1, the Centers for Disease Control and Prevention ("CDC") published in its publication, Morbidity and Mortality Weekly Report ("MMWR"), the results of a study that confirmed the epidemic of overdoses of opioid pain relievers ("OPRs") has continued to worsen particularly from 1999-2008. OPR deaths now account for more drug overdose deaths than heroin or cocaine combined and represent nearly 75% of all prescription drug overdose deaths. Drug overdose deaths (36,450) are now almost as high as the number of deaths from motor vehicles (39,973), which is the leading cause of injury death in the United States.
What is also alarming is that the OPR overdose rates have continued to rise despite increased warnings and recommendations over the past decade for voluntary education of health-care providers about more cautious use of OPRs. According to the MMWR, the death rate of drug overdoses of 11.8 per 100,000 population (nearly 100 people per day) is about three times the rate in 1991. Since 1999, most of the drug overdose increases have been attributed to prescription drug overdoses. In 2009 alone there were 1.2 million emergency department visits related to misuse of pharmaceuticals, which represented a 98.4% increase from 2004, compared to 1.0 million for use of the illegal drugs heroin and cocaine.
According to the MMWR, sales of OPRs quadrupled between 1999 and 2010 so that by 2010 enough OPRs were sold to mediate every American adult with a typical dose of hydrocodone every 4 hours for 1 month. Increased use of OPRs has contributed to overall increases in overdose death and nonmedical use. Yet the total number of prescribers responsible for the increase appears to be small: one study found only 3% of physicians accounted for 62% of the OPRs prescribed. Once prescribed, OPRs may be diverted for nonmedical uses (i.e., to patients for whom the drug was not prescribed or for other uses not attributed to pain for whom the drug was prescribed) or sold on the street. In 2010, 4.8% of the U.S. population 12 and older reportedly used OPRs nonmedically. This, in turn, cost insurance companies up to $72.5 billion in health-care costs.