TL neuro

March 3, 2014

Misuse of Prescription Opioid Medications

Filed under: Drug Overdose, Opiates — mtaffe @ 11:50 am

CDC-allopioidODsThis post will initiate a new conversation on this blog about the detrimental health effects of the non-medical use and misuse of prescription opioid medications such as Oxycontin, Vicodin and Percocet. The overdose death of beloved US actor Phillip Seymour Hoffman recently re-focused attention on prescription drugs. Mr. Hoffman had reported in 2013 that he had relapsed to heroin use subsequent to a prescription drug use episode. This, after a 23 year interval of recovery from drug use in his 20s.
It isn’t made specifically clear that Mr. Hoffman’s 2013 relapse was with prescription opioid analgesics and the autopsy report after his death reported he was taking benzodiazepine medications in addition to heroin. Nevertheless, this case echos a recent trend for an increase in prescription opioid overdoses in the general US population. Data from the CDC (obtained in this case from a NIDA site) show the increase in unintentional overdose deaths from 1999-2008.

Subramaniam-teenadmissionsA meeting report by B.M. Kuehn (2010) illustrates data sourced to G. Subramaniam showing an increase in prescription opioid treatment admissions for adolescents over a similar interval. This trend for adolescents is reflected in broader data reported by the Treatment Episode Data Set for all people 12 and older. This post outlines and graphs the relative increase for prescription opioids which reached 8.6% of all admissions in 2010 following a steady increase from about 1999 onward. In contrast admissions for stimulant treatment were in decline from 2006-2010 and heroin-related admissions were approximately stable from 2000-2010.

There are other data sources available which point to a very clear picture. The extra-medical use and abuse of opioid medications has been growing for nearly 15 years in the US. This has led to clear implications for health, including dependence and overdose deaths. A recent paper by Cicero and colleagues indicates that medications that contain oxycodone and hydrocodone are highly preferred in individuals that are opioid dependent. Recent papers from Mars and colleagues and from Young and Havens show that most young users of heroin had a prior history of extra-medical use of prescription opioids. Thus the downstream impact of prescription opioid misuse may extend to individuals who are no longer using prescription medications as their primary substance of abuse.

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The lab has recently begun a new NIH funded project on prescription opioids: R01 DA035281

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