By Kristina Fiore, Staff Writer, MedPage Today
The rise in abuse of and deaths from prescription opioid narcotics has reached epidemic proportions, government officials said today during a CDC event for physicians.
There were more than 27,000 deaths from prescription drug overdoses in 2007, a number that has risen five-fold since 1990, according to data the agency presented during its latest Grand Rounds discussion, which features different public health topics.
Just about the only mortality statistic that is getting worse is death from prescription opioid abuse, said CDC director Thomas Frieden, MD, MPH, referring to a comprehensive report on the nations health released yesterday that showed declining mortality rates for all other conditions, including heart disease and cancer.
Frieden said overdose deaths from prescription opioids are exceeding deaths from heroin and cocaine overdoses combined.
Also, the overall number of drug-induced deaths which includes all drugs, not just prescription painkillers, although it is attributable in large part to those is approaching the number of deaths from motor vehicle crashes.
Drug abuse deaths have also surpassed the number of deaths from suicide, homicide, and fire arms, Frieden said.
Its a major public health problem that is getting worse, and getting worse rapidly, he added.
Indeed, the CDC report found that unintentional injuries increased dramatically among patients ages 25 to 64 over the last decade.
Between 1997 and 2007, unintentional injury jumped 21% among patients ages 25 to 44, with poisoning which includes drug overdose accounting for 42% of those deaths in 2007.
For patients ages 45 to 64, unintentional injury rose 42% over those 10 years, and poisoning was the cause in 37% of those deaths.
The event featured four government officials, including Grant Baldwin, PhD, MPH, director of the CDCs division of unintentional injury prevention, Len Paulozzi, MD, MPH, an epidemiologist in that division, and Gary Franklin, MD, MPH, the medical director of the Washington State Medical Agency.
The featured panelist was U.S. drug czar Gil Kerlikowske, director of the White Houses National Drug Control Policy office.
You have all the key players acknowledging this problem, said Andrew Kolodny, MD, chair of psychiatry at Maimonides Medical Center in Brooklyn, N.Y., who was not involved in the panel but watched via webcast. This looks like a positive step in the right direction.
Kerlikowske said his office is currently reviewing President Obamas proposed drug policy, which was submitted last May, and noted that the administration has put the prescription painkiller epidemic at the top of its list of priorities in this field.
Kerlikowske also advocated for better prevention strategies, including setting up better prescription drug monitoring programs (PDMPs) to reduce opportunities for doctor-shopping and diversion.
Panelists floated a host of other prevention strategies. Paulozzi said insurers can be at the forefront by putting limits on the amount of claims physicians and pharmacies can submit, and Medicaid can restrict payment for inappropriate use of long-acting opioids for short-term pain.
Officials also called for more help from states, citing Washington states example ofnew laws on opioid dosing set to go into effect in June of this year.
Franklin said the law will require physicians to contact a pain specialist if patients exceed an opioid dose of 120 mg/day morphine equivalent and still have no remedy to their pain.
The same policy was implemented as a guideline recommendation since 2007, Franklin said, and has already been reflected, along with other state programs, in preliminary data on moderating rates of mortality and overdose hospitalizations.
Officials also called for better efforts at reducing barriers to primary care treatment of
- Opioid intoxication All Information (umm.edu)
- Drug oversight lags as deaths increase (chron.com)
- MDs over-prescribing narcotics? (healthzone.ca)