The National Safety Council has declared prescription drug overdoses in the U.S. to be a “national epidemic.” That’s a pretty strong statement, but the NSC backs it up with facts and makes recommendations on how to reverse the trend.
Merriam-Webster’s Dictionary defines epidemic as something that is “excessively prevalent.” The U.S. Centers for Disease Control and Prevention has also called this problem an epidemic.
Here are the stats to make that argument:
- Drug overdoses have now surpassed traffic crashes as the leading cause of injury death in the U.S.
- 38,329 people died of drug overdoses in 2010. 16,651 of these involved prescription opioids.
- Since 1999, the number of people who have died from prescription drug overdoses each year has more than doubled.
- 45 people die every day from overdoses of prescription pain relievers. This is twice the number of fatal overdoses from illegal drugs. It’s more than three times the number of people who die per day due to occupational injuries.
- Drug treatment admissions for prescription opioids increased seven-fold between 1998 and 2010, from 19,941 to 157,171.
- There are nearly two million people in the U.S. who are currently addicted to opioid pain relievers.
- One in six teens have misused or abused prescription pain relievers in their lifetime.
- Through the latter half of the 1990s and into the last decade, doctors, dentists and other providers prescribed opioid pain relievers more frequently as a part of patient care. From 2000 to 2009, the number of opioid prescriptions per 100 people increased by 35% and the number of morphine milligram equivalents prescribed doubled.
In a report distributed to attendees at its 2013 Congress and Expo, the NSC also points to this stat: States with the largest sales of opioid painkillers also have the highest mortality rates from them.
Why is the problem worse in some states than others? From state to state, several factors vary.
The NSC rated the states on these four factors:
- state action and leadership
- prescription drug monitoring
- responsible prescribing, and
- overdose prevention.
- Only three states (Kentucky, Washington and Vermont) meet these standards.
- Ten states partially meet the standards and are making progress.
- 23 states partially meet the standards but improvements are needed, and
- 14 states (Arizona, New Hampshire, Idaho, Kansas, Missouri, Delaware, Iowa, Maine, South Carolina, Wyoming, Hawaii, Nebraska, Pennsylvania and South Dakota) do not meet the standards.
What needs to be done
The NSC has several suggestions for curbing the prescription drug abuse epidemic.
Improve state prescription drug monitoring programs (PDMPs). Here are five specific recommendations:
- Make PDMPs easier to access by adding authorized users, including prescribers, dispensers, law enforcement, coroners/medical examiners, licensing boards and state insurance programs such as Medicaid.
- Allow prescribers and dispensers to delegate PDMP access to other medical professionals.
- Move to real-time PDMP data collection, collecting data from dispensers at least weekly.
- Share PDMP data from state to state, and
- Issue proactive PDMP alerts to prescribers, dispensers, law enforcement and licensing boards.
Prescribe opioids responsibly. NSC gives four specific recommendations:
- Pass pill mill legislation that regulates pain clinics and pain management services. Florida, Kentucky and Ohio have done this, and the result has been a reduction of the sales of prescription painkillers.
- Enact prescribing guidelines for doctors. Washington has seen success in reducing overdose deaths and the amounts of opioid pain relievers prescribed after it implemented prescribing guidelines.
- Provide more education to prescribers. It’s recommended that healthcare providers keep their knowledge of pain management current by taking continuing education classes.
- Increase the use of state PDMPs. Seven states have increased use of their PDMPs by requiring medical professionals to access it before issuing prescriptions for certain types of drugs or if the meds are used at certain intervals. Since doing this, Kentucky saw information requests to its PDMP increase by six times.
Make overdose education and naloxone more available. Opiate overdoses are reversible with timely administration of the drug naloxone, which is available by prescription. Naloxone can be administered as an injection or nasal spray. Massachusetts allows community programs to provide naloxone to trained people with a standing order from the health department. The program provides the drug to the people most likely to witness and intervene in an overdose, such as law enforcement officers and friends and family members of drug users.
What we all can do
Many of the NSC’s recommendations have to do with how these drugs are prescribed legally. There’s a good reason for that: Many of the problems are not related to illegal dealing in these drugs. It’s more often the case abusers get the drugs from family or friends. Some examples mentioned at sessions at the NSC Congress:
- People, including teens, search the medicine cabinets of family and friends and take a number of pills, maybe five or six, that might go unnoticed.
- In one case, an abuser visited real estate open houses to find the drugs in medicine cabinets, and
- One police department in Texas found one of its employees was illegally selling prescription pain relievers to another employee. (The worker thought she was doing her co-worker a favor because the employee couldn’t get the prescription pain relievers herself. The co-worker also said she was selling the drugs because she needed the extra money.)
The message behind that last point: If illegal sales happen within a police department, they can happen anywhere.
Safety pros can encourage these practices by employees:
- Don’t share prescription pain relievers with other people (and don’t sell them … it is illegal). If you received a prescription for pain relievers and didn’t use all the pills, find a community drug disposal program to get rid of the extras in the proper manner.
- Store prescription pain relievers in places where an abuser wouldn’t easily find them.
- Don’t self medicate. Some people keep prescription pain relievers they don’t use, and when a different kind of pain pops up, they go back to taking the pills. Always seek a doctor’s help with pain management.
- Make workers aware of employee assistance programs (EAPs) which can help them with a prescription pain reliever addiction.