A study published by Penn State University revealed that overdose deaths from prescription opioids in the U.S. quadrupled from 1999 to 2015, reaching 22,000 in 2015. This increase has been fueled by a dramatic rise in the amount of opioids being prescribed, creating a vast supply of drugs at high risk for misuse. Prescribers, therefore, are a vital link in addressing the current epidemic of overdose deaths and substance use disorders. The challenge is to develop and implement systems that help prescribers identify potential cases of misuse or diversion, while still allowing appropriate prescribing of opioids for pain control.
A recent article on the Healthcare Law Today web site discussed how telemedicine providers are dealing with e-prescribing and controlled substances. As providers become more comfortable with delivering care via telemedicine, telehealth, and digital health technologies, some are exploring services beyond low acuity consults. One area of opportunity – and notable confusion – is prescribing controlled substances via telemedicine. This particularly affects specialties that couple chronic disease management with pharmacotherapy.
- $55 billion in health and social costs related to prescription opioid abuse each year
- $20 billion in emergency department and inpatient care for opioid poisonings
- On an average day in the U.S. more than 650,000 opioid prescriptions dispensed
- 3,900 people daily initiate nonmedical use of prescription opioids
- 580 people initiate heroin use
- 78 people daily die from an opioid-related overdose
- Of the 20.5 million Americans 12 or older that had a substance use disorder in 2015, 2 million had a substance use disorder involving prescription pain relievers and 591,000 had a substance use disorder involving heroin
- An estimated 23% of individuals who use heroin develop opioid addiction
- Drug overdose is the leading cause of accidental death in the US, with 52,404 lethal drug overdoses in 2015.
- Opioid addiction is driving this epidemic, with 20,101 overdose deaths related to prescription pain relievers, and 12,990 overdose deaths related to heroin
- Over 259 million prescriptions were written for opioids, which is more than enough to give every American adult their own bottle of pills
- Four in five new heroin users started out misusing prescription painkillers
- People often share their unused pain relievers, unaware of the dangers of nonmedical opioid use.
- Most adolescents who misuse prescription pain relievers are given them for free by a friend or relative
- The prescribing rates for prescription opioids among adolescents and young adults has nearly doubled
- Women are more likely to have chronic pain, be prescribed prescription pain relievers, be given higher doses, and use them for longer time periods than men
- Women may become dependent on prescription pain relievers more quickly than men
- 48,000 women died of prescription pain reliever overdoses between 1999 and 2010.
When opioids are to be used to treat psychiatric or pain disorders, the practitioners must educate themselves regarding the neuroscience of opioids so that they can competently prescribe these medications for use in psychiatric and chronic pain syndromes. At a minimum, the treating healthcare professional should be aware of some of the more common medical side effects of the opioids.