Recent findings from three American universities indicate that doctors’ overprescription of opioid medications is a driving force for new cases of opioid addiction, not recreational opioid abuse outside of an approved medical context.
Opioid addiction and opioid overdose are increasingly prominent public health issues in the U.S. Among scientists, public health officials and the general public, much of the focus on these issues has centered on consumption of opioid substances in a manner not sanctioned by a doctor. In a study published in January 2015 in the Annual Review of Public Health, an American research team assessed the role that overprescribing by doctors plays in promoting new cases of opioid addiction and overdose. The researchers concluded that doctors’ prescribing practices constitute the primary force behind such cases throughout most of the 21st century.
Opioid Prescribing in the U.S.
In the U.S., opioid medications are usually prescribed as treatments for various forms of serious pain, including severe pre- or post-surgical pain and pain stemming from accidental or intentional injuries. In certain medical contexts, opioids may also be prescribed for less severe forms of pain or for diarrhea or coughing that doesn’t improve after the use of other treatments. Two of the most commonly prescribed opioids, oxycodone and hydrocodone, appear in a number of well-known medications (including oxycodone-based OxyContin and hydrocodone-based Vicodin). Other common opioid medications include morphine, codeine, hydromorphone and fentanyl.
Opioid prescribing rates have increased steeply in America since the beginning of the 2000s. According to figures compiled by the federal Centers for Disease Control and Prevention, U.S. doctors prescribed opioid painkillers some 259 million times in the year 2012. This is roughly the equivalent of one prescription for every man and woman in the country. However, opioid prescribing practices are not uniform throughout the nation. In fact, in states with the highest prescribing rates, doctors authorize the use of opioid medications almost 200 percent more often than in states with the lowest rates. Overall, American adults receive prescriptions for opioids roughly 100 percent more often than their counterparts in Canada (another nation noted for its unusually high rate of opioid medication consumption).
The term drug abuse has both a general and specific meaning. In its general sense, the term applies to any form of recreational or therapeutic drug or medication intake that occurs outside of a physician’s supervision, as well as to the misuse of a legitimately issued prescription. In its more specific sense, the term applies to a diagnosable pattern of dysfunctional substance intake not associated with the presence of physical dependence or addiction. In the general sense, Americans abuse opioid medications more often than they abuse any other type of prescription medication. In turn, a high rate of inappropriate intake can increase society’s risks for diagnosable opioid abuse/addiction, as well as for episodes of fatal or non-fatal opioid overdose.
Role of Opioid Overprescription
In the study review published in the Annual Review of Public Health, researchers from Brandeis University, the University of North Florida and Johns Hopkins University examined the patterns of opioid prescribing throughout America in the 21st century as part of an effort to determine the role that overprescription of these medications may play in rising rates of opioid addiction and opioid overdose. The researchers undertook their project, in part, because the rise in opioid-related addiction roughly parallels sharp increases in the prescribing of opioid medications among America’s doctors.
After completing their review, the researchers found that, while diagnosable cases of opioid abuse/addiction have risen steeply since the late 1990s, the nationwide rate of opioid abuse (in the general recreational sense) has actually decreased substantially since the year 2002. They also found that the rate of opioid overdose has gone up sharply in recent years. The researchers concluded that the chief explanation for this somewhat paradoxical situation is the increased rate of opioid prescribing among U.S. physicians. They further concluded that opioid abuse in the general sense (specifically, recreational use of an opioid medication not prescribed by a doctor) is not an essential contributor to the nation’s rising rates of opioid addiction and opioid overdose.
The study’s authors believe that doctors in the U.S. may overestimate the treatment effectiveness of opioid medications while simultaneously underestimating the dangers associated with the widespread prescribing of these medications. Such thinking echoes recent findings by other researchers who have concluded that prescription opioids have limited verified usefulness as a medical treatment.