New research suggests that abuse of narcotic painkillers may be on the decline, following the implementation of local and national intervention programs designed to address what has been described as a national epidemic.
According to findings published in the New England Journal of Medicine on January 15, rates of opioid painkiller use declined from 2011 to 2013, after a period of substantial increase between 2002 to 2010.
While many factors may play into the reasons for the drop, researchers point to specific interventions implements to mitigate the rising trend of prescription painkiller abuse.
The study focused on data from five programs from the Researched Abuse, Diversion, and Addiction-Related Surveillance (RADARS) System. RADARS is specifically designed to tack illicit use of narcotic painkillers.
Prescription narcotic painkiller use had been increasing in the United States over the last two decades. In 2010, there were nearly 17,000 deaths attributed to prescription opioid use or abuse, and a study published late last year revealed the number of deaths attributed to opioid painkillers quadrupled between 1999 and 2011.
The latest study focused on six formulations of prescription painkiller use: oxycodone, hydrocodone, hydromorphone, fentanyl, morphine and tramadol. The data was taken from drug-diversion investigators, poison centers, substance-abuse treatment centers and college students.
RADARS reported large increases in the rates of opioid abuse from 2002 to 2010. The rates then flattened, and eventually decreased from 2011 through 2013. Rates of opioid related deaths also rose and fell during this period in a similar pattern.
Interventions, Programs Working
Researchers said that while there may be many reasons prescription narcotic use is declining, several factors are at play.
Many federal, state and local governments and organizations are actively combating the threat, which the U.S. Centers of Disease Control and Prevention referred to as an “epidemic”, through interventions and drug abuse prevention programs. The interventions included new laws, programs, policies, and tracking systems.
Additionally, the FDA is pushing to make the drugs themselves more resistant to abuse. This has included a reformulation of the popular painkiller oxycodone, to a more abuse resistant form. In 2013, the FDA also issued new requirements for narcotic painkiller drug labels to offer stricter warnings and safety language concerning extended release options.
“This is a condition that a lot of employed and working people get because they get their opioids for a good reason because they had surgery, for example,” said Dr. Richard Dart, lead author of the study. “Then they find out they’re susceptible and get addicted. Both patients and physicians need to say, ‘Do I really need this opioid?'”
While the decreases are promising, researchers are also concerned that the decrease may be in part because of users move toward cheap heroin following the release of abuse-resistant painkillers.
Research published in 2013 revealed opioid painkiller prescription nearly doubled over the past decade. However, the number of opioid painkiller prescriptions began to level off in 2011 in every state, except for Missouri.
Researchers are hopeful of the new results, but remain concerned about the high number of narcotic painkiller users and deaths.
“These findings suggest that the United States may be making progress in controlling the abuse of opioid analgesics,” Dart said.
While the United States accounts for only about five percent of the world’s population, it accounts for more than 80% of prescription opioids used. More people die each year from narcotic painkiller related incidents than from vehicle collisions.