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Stop Overdose Deaths Involving Prescription Drugs: A Multi-faceted Approach

Categories: Home & Recreational Safety

Pill bottle

Nationally, deaths from drug overdose were second only to motor vehicle crashes among leading causes of unintentional injury death in 2007.

Guest blogger – Len Paulozzi, MD, MPH

Heath Ledger. Anna Nicole Smith. I’m sure you saw the news stories when these celebrities died unexpectedly. Did you also hear about Shannon Anderson? Or Derek Barnes? Probably not. Yet they—and thousands more—share a significant connection to the celebrities. They all died of unintentional drug poisoning.

Unintentional drug poisoning includes drug overdoses resulting from drug misuse, drug abuse, and taking too much of a drug for medical reasons. While we may associate these overdose deaths with celebrities, this public health concern is not a distant “Hollywood” problem. More than ever before, stories of drug overdose deaths are part of your local news—especially in rural areas of the United States that traditionally have not been affected by drug problems.

Nationally, deaths from drug overdose were second only to motor vehicle crashes among leading causes of unintentional injury death in 2007. Drug overdose death rates in the United States have risen steadily since 1970, and we should all be alarmed by how quickly the numbers have increased. Death rates more than doubled between 1999 and 2007, when more than 28,000 deaths from unintentional drug poisoning occurred; that’s more than 75 deaths per day.

Among deaths attributed to drugs, the most common drug categories are cocaine, heroin, and a type of prescription drug called opioid painkillers. These painkillers have the ability to reduce pain but, when taken in excess, also can suppress breathing to a fatal degree. Our data suggest that the increase in drug overdose death rates is largely related to prescription opioid painkillers, such as oxycodone (OxyContin®), hydrocodone (Vicodin®) and methadone. There has been at least a 10-fold increase in the medical use of opioid painkillers since 1995, resulting from a movement toward more aggressive management of pain. By 2006, opioid painkillers were involved in more overdose deaths than heroin and cocaine combined due in part to legal prescriptions being used illicitly. And rural America is particularly at risk, with states in the Appalachian region and the Southwest having the highest death rates.

A recent study on prescription drug use by the Utah Department of Health found that medical providers commonly prescribe more doses of painkillers than patients use and that patients generally don’t dispose of leftover medications. Utah issued guidelines focused on reducing the number of leftover medications and informing patients about disposing of unused medications properly.

These are positive steps. Yet we know that this approach, which asks patients to manage their drug use and limit leftover drugs in their households, won’t solve the problem by itself. Studies show that those who overdose on prescription drugs generally have had a pattern of abuse. We must address this public health crisis with additional public health resources and proven interventions.

The Injury Center has developed recommendations based on promising interventions and expert opinion. In part, we encourage health care providers to use opioid medications only after determining that alternative therapies do not work. If opioids are prescribed, patients should be monitored closely for signs of inappropriate use. Insurance providers, pharmacies, and pharmacy benefit managers also have responsibilities, as they can help identify patients who have prescriptions for the same drug from multiple providers and limit that access. State and federal agencies, to the extent provided by law, should consider more robust monitoring for inappropriate use of controlled substances and work to improve the availability of substance abuse treatment services. We know that treatment works, yet only a fraction of those who need treatment for drug abuse receive it.

We must try to prevent unintentional drug overdoses through education and enforcement—working with all public health entities and other relevant stakeholders. Now is the time to address this public health crisis and help communities change the local news about unintentional drug overdoses. It’s up to all of us, working together, to make a difference.

Dr. Len Paulozzi is a medical epidemiologist for the Division of Unintentional Injury Prevention at the CDC National Center for Injury Prevention and Control.

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  1. June 28, 2010 at 12:20 pm ET  -   Tweets that mention CDC - Blogs - CDC Injury Center: Director’s View Blog - Stop Overdose Deaths Involving Prescription Drugs: A Multi-faceted Approach -- Topsy.com

    [...] This post was mentioned on Twitter by SHHIP, SPHERE. SPHERE said: #CDC blogs on #overdose deaths from prescription drugs http://tinyurl.com/267c5ok [...]

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  2. June 30, 2010 at 1:57 pm ET  -   Tweets that mention CDC - Blogs - CDC Injury Center: Director’s View Blog - Stop Overdose Deaths Involving Prescription Drugs: A Multi-faceted Approach -- Topsy.com

    [...] This post was mentioned on Twitter by CDC_eHealth and others. CDC_eHealth said: Prescription drug overdoses are not just a Hollywood problem! Find out how CDC is responding: http://is.gd/daedd [...]

    http://topsy.com/trackback?url=http%3A%2F%2Fblogs.cdc.gov%2Fncipc%2F2010%2F06%2F24%2Fstop-overdose-deaths-involving-prescription-drugs-a-multi-faceted-approach%2F%3Fs_cid%3Dtw_eh_125&utm_source=pi

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  3. June 30, 2010 at 3:05 pm ET  -   Tweets that mention CDC - Blogs - CDC Injury Center: Director’s View Blog - Stop Overdose Deaths Involving Prescription Drugs: A Multi-faceted Approach -- Topsy.com

    [...] This post was mentioned on Twitter by January W. Payne, Bill Fredericks. Bill Fredericks said: Deaths on the rise with presciptions that may just be in your own medicine cabinet http://fb.me/BgsNtalF [...]

    http://topsy.com/trackback?url=http%3A%2F%2Fblogs.cdc.gov%2Fncipc%2F2010%2F06%2F24%2Fstop-overdose-deaths-involving-prescription-drugs-a-multi-faceted-approach%2F%3Fs_cid%3Dfb397&utm_source=pingba

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  4. July 2, 2010 at 7:31 am ET  -   Roy Kamen

    I agree that way too many drugs are being prescribed. The way to better health is through proper nutrition and exercise. Its too easy to pop a pill to cure what daily movement could achieve.

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  5. July 27, 2010 at 7:52 pm ET  -   Kyiah Shekanna Evans

    Thank you for your article. My 20 year-old daughter died 02/28/2010 of an accidental prescription drug overdose. She took Methadone, hydrocodone, metabolite, diazepam, clonazepam,meprobamate, gabapentin and sertraline.

    I would like to see research on the effects of Rx advertisements on television. I believe these advertisements are killing our young people. I think they should be out-lawed, and I would be willing to work towards that cause, but need research that shows a correlation to back it up. I am requesting this agency to do this research. Tobacco advertisements were removed, and there is a decrease in tobacco related deaths because of it. The same thing needs to happen with prescription drug advertisements. In addition, there needs to be a media blast of how to dispose of prescription drugs, and lock them up, so they do not end up in the wrong hands.

    Thank you for any feedback you may have for me to help make these changes.
    Kyiah Shekanna Evans, LCSW

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    • AUTHOR COMMENT August 11, 2010 at 7:28 am ET  -   directorsview

      Ms. Evans,

      Please accept my condolences on the loss of your daughter. And thank you for your interest in taking steps to help keep others from experiencing this type of tragic loss. The Food and Drug Administration is the group that is responsible for the regulation of prescription drug advertisements on television. You can contact them and share your suggestions here: http://www.fda.gov/AboutFDA/ContactFDA/default.htm.

      Len Paulozzi, MD, MPH
      Medical Epidemiologist
      Division of Unintentional Injury Prevention
      CDC National Center for Injury Prevention and Control

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  6. October 8, 2010 at 3:10 pm ET  -   American Medicine Chest Challenge

    Prescription drug abuse is a problem in our country. The 2007 National Study of Drug Use and Health found that 70% of people who abuse prescription pain relievers indicated they got them from friends or relatives, and the National Institute of Drug Abuse (NIDA) reports that upwards of 9 million people use prescription medication for non-medical uses.

    The American Medicine Chest Challenge is a community based public health initiative, with law enforcement partnership, designed to raise awareness about the dangers of prescription drug abuse and provide a nationwide day of disposal – at a collection site or in the home – of unused, unwanted, and expired medicine that will be held on November 13, 2010 in communities across the country.

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  7. February 20, 2011 at 9:02 pm ET  -   Leah Baker

    I haven’t seen any mention of Narcan on this entire page! Narcan (Naloxone Hydrochloride) is effective in reversing most opiate overdoses and is used in ER’s, by paramedics, hospitals, not to mention by people that use opiates themselves, if it is available to them through needle exchange programs, or from their doctors. Perhaps doctors and pharmacists should be educated so that they can pass on information about naloxone to the people getting opiate prescriptions. Educating people is more effective that policing them. True, pain pill prescriptions are handed out more than probably necessary, but no one needs to die from an opiate overdose.

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  8. March 7, 2011 at 10:31 pm ET  -   Crusader

    Drug companies have become legal drug dealers. They are mass murderers for profit. Benzodiazapans and oxycodone among others are the poisons drug companies are peddling. They are killing young adults at a rate that will soon surpass automobile accidents, illegal drug overdoses, alcohol related deaths and gun related deaths combined. One company is spending 400 million per year for staff attorneys and 100s of millions per year for security. This company is making billions per year peddling their unspeakable poisons. 40,000 deaths due to prescription drug overdoses for 2011 is a conservative forcast. Who will stop the slaughter.

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  9. March 13, 2011 at 8:41 pm ET  -   Helen

    I know in my area I have watched to many people deal with addiction and drug abuse. I think one of the best things to do is to listen to those that have had experience with drugs and alcohol. They know from experience. I am watching a friend right now from an area dealing with a lot of problems with prescription drugs that the problems are not just your old school crack or heroin junkie, the can be found in your medicine cabinet and maybe one day we can have more people having a forever recovery from drugs and alcohol.

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  10. May 28, 2011 at 8:23 am ET  -   Katie

    As a nursing student I knew that drug misuse and overuse was a serious problem, but I had no idea of the dramatic increase of deaths over the past 30 years. As nurses we have been trained that pain is what the patient says it is, and pain control is one of the most important things we can do for our patients. Since we have the technology and the medications, no one should have to suffer from pain that can be easily managed. However, there is a fine line between managing pain and using excess. I know that part of the problem is the vast quantity of pain medications that are available to the public (legal or otherwise) and this has risen over the past few decades. Another reason that more deaths might be occuring is because of the confusing with the different types of drugs, the ways to take them, the times to take them, etc. Prescriptions can be confusing and lots of medication errors happen in the home. This high death rate is a serious problem and something that needs to be addressed, however, there is going to be difficulty in changing anything about the way that prescriptions are given, because medical professionals want their patients to have adequate pain control. Having pain under control allows for quicker healing because they are able to get up and move, breathe, and have a positive outlook on their situation. This is something that I am going to stay informed of as I move through my career. Thanks for the interesting post!

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  11. October 20, 2011 at 4:58 pm ET  -   Joan Sura

    Prescription drug addiction such as the Psychological- and/or Chemical Dependence on pharmaceuticals has become an increasingly escalating problem among people within all classes of society. According to statistics that were recently published on the internet, we may conclude that prescription drug addiction is increasingly exceeding other known addictions such as the consumption of alcoholic beverages, and the frequent abuse of illegal class I controlled substances.

    Joan Sura Wilson

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  12. November 11, 2011 at 11:17 pm ET  -   S.B.Hall

    This was an interesting post. I knew that prescription drug abuse was a problem but had no clue that it was the second leading cause of death in the United States next to automobile accidents. I appreciate that this is not a “Holly wood” problem was highlighted because that is a common misconception, but I do not agree with the comments that pharmaceutical companies are “legal drug dealers”. The pharmaceutical companies are regulated by the FDA, it’s the people taking the drugs that need more attention. Many believe that because a drug is doctor prescribed that it is not really a drug and can’t be addictive, or think it is okay to get pills from a friend. Even college students, graduate students, and law students have been found to trade prescription drugs such as Ritalin to stay focused. Although pharmaceutical companies and doctors do play a role in this rising problem is ultimately the person taking the drug that is misusing the drug and unfortunately faces the consequences. I think that educating people with blogs such as this, adding more information to health classes, and giving out information at hospitals and doctors’ offices will help to make people realize that drug addicts aren’t just the people on the corners with needles, but can also be the person in the corner office with the prescription drug bottle.

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  13. December 25, 2011 at 12:20 am ET  -   Suzanne Lee

    it remains astounding to me that this problem of prescription opoiod overdoses in epidemic numbers is allowed to continue! I get it, that it is hard to get the horse back in to the stable, but COME ON! We simply did not have this problem 15-20 years ago before the medical community decided that pain was undertreated and needed to be aggressively targeted. Doctors and researchers and pharmaceutical companies, along with governmental regulatory bodies, all proclaimed that the use of chronic opioid therapy (COT) for chronic non-cancer pain (CNCP) could be done without creating addiction. Now we know that those prognosticators were wrong! Recent studies show that over a third of patients on COT become addicted to them. No one dies from pain but people do die from the treatment of it. We must all demand a halt to the practice of COT for CNCP as it is currently practiced. There must be greater oversight, education, and sanity infused into this iatrogenic problem!

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  14. February 12, 2012 at 11:03 am ET  -   Lily Rose Peabody

    I was talking to a young man who told me of the recent deaths of a number of his friends due to heroin overdose. He said that heroine is becoming the drug of choice among youth because it is so cheap and so pure. It sounded like a terrorist plot from the middle east. If they flooded our youth with cheap and highly addictive/deadly drugs it could debilitate our most precious resource…the next generation. In the book, “Three Cups of Tea” the terrorists are focused on educating /brainwashing their most intellegent youth. Could they concurrently be trying to destroy our youth with drug addiction?

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