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Deaths from OD of Rx Painkillers Triple in 10 Years
Deaths caused by overdoses of prescription opioid painkillers more than tripled over a decade, to nearly 15,000 in 2008, CDC researchers found.
That's up from 4,000 in 1999, Len Paulozzi, MD, of the CDC, and colleagues reported in Morbidity and Mortality Weekly Report and in a Vital Signs brief.
"These increases occurred despite numerous warnings and recommendations over the past decade for voluntary education of providers about more cautious use of prescription opioid painkillers," they wrote.
In 2008, there were 36,450 drug overdose deaths in the U.S. -- a close second to the leading cause of death from injury: motor vehicle crashes, which totaled 39,973 that year.
The total, and the increase, have been driven largely by prescription painkiller abuse, the researchers said, noting that overdose death from these drugs has surpassed deaths tied to heroin and cocaine combined.
Rx opioid overdose death rates were higher among whites and American Indians/Alaskan Natives than among blacks and Hispanics.
There was also tremendous variation in death rates by state, ranging from 5.5 per 100,000 population in Nebraska to 27 per 100,000 in New Mexico.
Prescription opioid sales were lowest in Illinois at 3.7 kg per 10,000 population, and highest in Florida, at 12.6 kg, and the highest sales rates tended to cluster in the Southeast and Northwest.
Generally, states with lower death rates had lower sales rates and lower rates of nonmedical use of prescription painkillers, Paulozzi and colleagues reported.
"State policy can make a huge difference in controlling or allowing this epidemic to proceed," Thomas Frieden, MD, director of the CDC, said during a press briefing.
Gil Kerlikowske, director of the Office of National Drug Control Policy -- which took aim at the prescription painkiller abuse "epidemic" last April -- said on the briefing that state prescription drug monitoring programs are one of the most effective measures to bring the tide of painkiller abuse under control.
Although only two states -- Missouri and New Hampshire -- don't have monitoring programs set up, many have had trouble funding them, and others are not being used as robustly as they could be, Kerlikowske said.
Ideally, Frieden said, these systems could help identify doctors and patients who are behaving irresponsibly and disproportionately contributing to the problem.
Paulozzi and colleagues added that the national rate of sales in 2010 -- 7.1 kg per 10,000 population -- was equivalent to 710 mg of prescription opioids per person in the U.S.
That's enough to medicate every American adult with a typical dose of 5 mg of hydrocodone (Vicodin, Lortab) every four hours for one month, they wrote.
Sales of prescription painkillers and admissions to substance abuse treatment programs have risen in lockstep with overdose death rates, Paulozzi and colleagues noted.
In 2008, sales were four times higher than they were in 1999, and treatment admissions were six times higher during the same period, they reported.
Much of the abuse can be attributed to "pill mills," or illegitimate pain clinics that dole out prescription opioids to nearly anyone who complains of pain, the researchers said.
"Now the burden of dangerous drugs is created by a few irresponsible doctors rather than drug pushers on street corners," Frieden said.
Public health interventions to reduce prescription drug overdose need to strike a balance between minimizing abuse while not jeopardizing legitimate access to treatment, they emphasized.
Thus, clinicians should use opioids only in "carefully screened and monitored patients when nonopioid treatments have not been sufficient to treat pain," they wrote.
"Improving the way prescription painkillers are prescribed can reduce the number of people who misuse, abuse, or overdose from these drugs," they added in the Vital Signs report.
Study data came from the National Vital Statistics System, which was limited by self-reported data, potential under-report, and exclusion of data on buprenorphine.
(11.01.2011, Kristina Fiore) http://www.medpagetoday.com/PublicHealthPolicy/PublicHealth/29383
A new report from the Centers for Disease Control and Prevention found nearly 40 Americans die per day -- about 15,000 per year -- from overdoses of painkillers such as Vicodin and OxyContin, eclipsing the number of deaths caused by heroin and cocaine combined.
"We are in the midst of an epidemic of prescription narcotic overdose," said Dr. Thomas Frieden, director of the CDC during a telebriefing to discuss the newly published data.
The problem of abuse, officials said, is getting worse. The number of deaths represents a three-fold increase over the past decade, and CDC also found that in 2010 alone, there were enough painkillers prescribed to supply every adult with a one-month supply.
"This stems from a few irreponsible doctors rather than by drug pushers on street corners," said Frieden.
It's also an expensive problem. Agency officials put the cost of nonmedical use -- misuse, for the most part -- of prescription painkillers at $72.5 billion based on government and insurance company data.
The sale of prescription painkillers and the number of related deaths vary by state, with Florida, New Mexico and Oklahoma being among the states hardest hit by the epidemic.
Back in April, the Obama administration announced a plan aimed at reducing the amount of prescription opioid abuse. One of the plan's goals is to reduce the abuse rate by 15 percent by 2015.
The plan called for the expansion of statewide prescription drug monitoring programs (PMDPs), programs that safely dispose of prescription painkillers as well as better education for patients and healthcare providers.
PMDPs electronically monitor painkiller prescriptions in each state. Only Missouri and New Hampshire do not have one in place. The other states and the District of Columbia are still trying to figure out how to get their programs up and running, CDC said.
Dr. Scott Fishman, professor of anesthesiology and pain medicine at the University of California-Davis and president of the board of the American Pain Foundation, said PMDPs can be effective at curbing misuse of prescription painkillers, but they aren't completely foolproof. He also advocates educating providers and patients.
"One of the problems is trying to get states to finance these programs," he said. Another issue is, since they are statewide and not nationally linked, people can just cross state lines and get prescriptions. The federal government, he added, needs to put a more robust program in place that can help monitor usage.
Another issue that could arise with these programs is the monitoring could be too strict, and doctors could be afraid to prescribe the medications.
"People are afraid that narcotics will be harder to obtain in appropriate situations, and I think that's what some of those concerns are about stricter prescription drug monitoring programs are," said Dr. Patricia Baumann, assistant professof of anesthesiology at the Emory Clinic in Atlanta.
Fishman added that a big part of the responsibility lies with providers who aren't properly trained.
"Doctors are not adequately trained in the area of pain management," he said. "There isn't enough focus on pain management in medical schools and beyond."
Patients who are treated for chronic pain should also understand the addictive nature of the medications and take steps to lower the risk of getting hooked on them and keeping them out of the hands of others.
"Patients need to keep them out of the reach of individuals who may not use them safely, keep them locked up, not use them with alcohol or other sedatives, and be aware of other disorders that may predispose them to pain."
"There are also conservative therapies available, such as non-narcotic pain medications and physical therapy," said Baumann. "There are numerous options that should be tried before you go to a narcotic pain medication." (11.01.2011, Kim Carollo, @kimcarollo) http://abcnews.go.com/Health/prescription-painkiller-overdose-deaths-rise/story?id=14858375
40,000 deaths in USA caused by aspirin and painkillers every year!
"Conservative calculations estimate that approximately 107,000 patients are hospitalized annually for nonsteroidal anti-inflammatory drug (NSAID)-related gastrointestinal (GI) complications and at least 16,500 NSAID-related deaths occur each year among arthritis patients alone." (Singh Gurkirpal, MD, “Recent Considerations in Nonsteroidal Anti-Inflammatory Drug Gastropathy”, The American Journal of Medicine, July 27, 1998, p. 31S)
"It has been estimated conservatively that 16,500 NSAID-related deaths occur among patients with rheumatoid arthritis or osteoarthritis every year in the United States. This figure is similar to the number of deaths from the acquired immunodeficiency syndrome and considerably greater than the number of deaths from multiple myeloma, asthma, cervical cancer, or Hodgkin’s disease. If deaths from gastrointestinal toxic effects from NSAIDs were tabulated separately in the National Vital Statistics reports, these effects would constitute the 15th most common cause of death in the United States. Yet these toxic effects remain mainly a “silent epidemic,” with many physicians and most patients unaware of the magnitude of the problem. Furthermore the mortality statistics do not include deaths ascribed to the use of over-the-counter NSAIDS." (Wolfe M. MD, Lichtenstein D. MD, and Singh Gurkirpal, MD, “Gastrointestinal Toxicity of Nonsteroidal Anti-inflammatory Drugs”, The New England Journal of Medicine, June 17, 1999, Vol. 340, No. 24, pp. 1888-1889.)
If you are good at maths, you can see that 40,000 Americans are killed each year by these drugs. And that makes them ten times more deadly than swine flu (because 40,000 is ten times greater than 4,000).
Check what to do in case of an acute back pain and if you hve to take painkillers, please do it with or staright after food with plenty of water. http://adjusthealth.info/health-news/89-40000-deaths-in-usa-caused-by-aspirin-and-painkillers-every-year
"To Achieve One World
Government it is necessary to remove from the minds of men their individualism,
their loyalty to family traditions and national identification." (Brock Chisholm - Director of the World Health Organization)
"A society whose citizens refuse to see and investigate the facts, who refuse to
believe that their government and their media will routinely lie to them and fabricate a
reality contrary to verifiable facts, is a society that chooses and deserves the Police
State Dictatorship it's going to
get." (Ian Williams Goddard)
The fact is that "political correctness" is all about creating uniformity. Individualism is one of the biggest obstacles in the way of the New World Order. They want a public that is predictable and conditioned to do as it's told without asking questions.
"The two enemies of the people are criminals and government, so let us tie the second down with the chains of the Constitution so the second will not become the legalized version of the first." Thomas Jefferson