Is OxyContin being Overprescribed?

in Pharma Interest

Statistics can paint an alarming tale of opioid drug addiction in the United States. Every day, 91 Americans die from an opioid overdose, according to the Centers for Disease Control and Prevention.

In 2015, the number of recorded U.S. drug overdose deaths tallied up to 52,404 deaths, 63.1% of which involved an opioid medication, research shows. At the time, the number of fatalities linked to drug overdoses was believed to the most ever recorded in American history. The year 2015 was also when the number of opioids prescribed was enough for every U.S. adult to be medicated around the clock for three weeks!

But the health crisis was far from over. In 2016, the annual governmental tally of drug-related overdose deaths hit 60,000, which was higher than that of the previous year. The numbers for 2017 are not in yet, but they aren’t expected to fare much better.

It is clear from these numbers that the decision to use potent drugs to treat chronic pain has helped usher in a national health crisis that has reached epidemic levels, one that has put many on the road to addiction and led many others to overdose, sometimes fatally.

Too Much OxyContin?

Physicians have been prescribing opioids such as OxyContin to help their patients manage chronic, moderate-to-severe pain since the late 1990s. Like most other drugs in this class, OxyContin affects the brain’s opioid receptors and changes how the body perceives and responds to pain. When misused and abused, users report feelings of euphoria that numb them to pain and allow them to get them high.

Oxycodone or OxyContin Chemical Structure
Oxycodone or OxyContin Chemical Structure

According to the CDC, oxycodone, or OxyContin (the time-release version of the drug), is one of the most commonly overdosed opioids along with hydrocodone (Vicodin) and methadone. Law-enforcement, government, and health officials are trying various strategies to decrease the number of people dying from opioid use.

There have been calls urging the Drug Enforcement Administration to reduce the production of oxycodone, morphine, and fentanyl to stem the supply of opioids in the United States.

Prescription drug monitoring programs, or PDMPs, also have been put into place in each state to track medications use and identify high-risk prescribing activity. However, the practice of overprescribing OxyContin, along with other addictive opioid drugs, has contributed to the problem, some observers say.

In 2016, the National Safety Council (NSC) released poll results showing that 99 percent of primary care physicians routinely prescribe opioid pain relievers for longer than the three-day period the CDC recommends. The poll also found that 74 percent of doctors think morphine and oxycodone, both opioid medications, are the most effective ways to treat pain, but this perception is incorrect, the NSC said.

Side effects of Oxycodone
Side Effects of Oxycodone

“Opioids do not kill pain; they kill people,” said Dr. Donald Teater, the organization’s then medical adviser in the news release. “Doctors are well-intentioned and want to help their patients, but these findings are further proof that we need more education and training if we want to treat pain most effectively.”

Observers say that improving the process of how opioids are prescribed can reduce the public’s exposure to opioids, prevent abuse, and help end addiction.

What is being Done about High-Risk Prescribing Practices?

In 2016, the Centers for Disease Control and Prevention issued guidelines that provide recommendations for how opioid medications should be prescribed for patients age 18 and older in primary care settings. The recommendations also encourage physicians to seek out alternative methods, such as talk therapy, among others, before treating chronic pain with opioid medications.

The guidance also advises medical professionals to use immediate-release opioids when starting pain treatment, to prescribe no more than needed, and reduce the patient’s dose or taper and discontinue if needed.

If it is determined that opioid therapy is the best course of action, then doctors are advised to start with the lowest dose possible of the pain medication they are using. They also are encouraged to discuss the benefits, risks, and availability of non-opioid therapies with their patients.

CVS Health is also taking steps to closely monitor the prescription pain relievers leaving its pharmacies. It recently announced that as of Feb. 1, 2018, it is limiting opioid medications for certain medical conditions to a seven-day supply to address the practices of overprescribing or misprescribing opioid medication as well as abuse of the medications. The new restriction is in alignment with the CDC’s prescribing guidelines.

Some Progress Made, But is It Enough?

In 2017, a CDC analysis of changes in opioid prescribing in the U.S. offered a small glimpse that things could turn around, though much more still needs to be done. The report found that the number of opioids prescribed in the US peaked in 2010, and then fell each year through 2015. This means some doctors prescribed opioids less often and at lower doses during that five-year period.

However, the prescribing rate for prescription opioids in 2015 was still about three times as high as it was in 1999. Prescription rates also varied widely across the U.S.

“Higher amounts of opioids were prescribed in counties with a larger percentage of non-Hispanic whites; a higher prevalence of diabetes and arthritis; micropolitan counties; and counties with higher rates of unemployment and Medicaid enrollment,” the CDC reports.

Doctors are also giving their patients prescriptions that last longer, something that increases the chances that a person can become addicted and overdose, possibly fatally.

Not All Opioid Abuse Starts with OxyContin, or Other Prescription Drugs

Government data tells part of the story about America’s opioid drug addiction crisis, as a 2017 study demonstrates. The data offers some insight into how opioid addiction starts for people who didn’t just fall into the addiction through prescription medications.

Some users are skipping prescription drugs altogether and going straight the street drug heroin to kick-start their opioid use, which is one reason why reducing the prescription drug supply might not be enough to stem opioid use.

In the study, it showed that in 2005, nine percent of nearly 6,000 first-time opioid users started with heroin, but by 2015, the number of first-time opioid users who started with heroin jumped to 33.3 percent.

The study also found that novice opioid users now prefer heroin is over hydrocodone and oxycodone.

Ultimately, the upshot is that this is a multi-faceted problem that won’t go away simply by curbing OxyContin prescriptions. To tackle this drug epidemic, we need to help everyone to help spread awareness and education about addiction.

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