Drug Safety Monday

The use and abuse of prescription painkillers is a growing problem in the U.S. Nearly three out of four prescription drug overdoses are caused by prescription painkillers—also called opioid pain relievers. These drugs were involved in nearly 15,000 overdose deaths in 2008, which was more than cocaine and heroin combined. Those most at risk for overdose include people who obtain multiple controlled substance prescriptions from multiple providers—a practice known as “doctor shopping”--and people with mental illness and those with a history of substance abuse.

The impact on the health system is dramatic. More than 475,000 emergency department visits were made in 2009 as a result of the use and abuse of prescription painkillers, a number that nearly doubled in just five years. For every one overdose death from prescription painkillers, there are 825 people who take prescription painkillers for nonmedical use.

Almost all prescription drugs involved in overdoses come from prescriptions originally; very few come from pharmacy theft. However, once they are prescribed and dispensed, prescription drugs are frequently diverted to people using them without prescriptions. More than three out of four people who misuse prescription painkillers use drugs prescribed to someone else.

Several policy solutions to prevent prescription drug overdoses exist. Prescription Drug Monitoring Programs (PDMPs), which collect data from pharmacies to detect sources of drug diversion, help prescribers and pharmacists identify high-risk patients who would benefit from early interventions. Other solutions include regulating unlicensed pharmacy technicians, public outreach and education campaigns on the dangers of prescription drug abuse, training for pharmacists and physicians to detect doctor shopping, and better access to substance abuse treatment.

For more information, see the Poisoning page of “Preventing Injuries in Maryland: A Resource for State Policy Makers," produced by the Johns Hopkins Center for Injury Research and Policy, and CDC’s website.