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Chronic Pain Primary Reason for Misused Prescription Opioids

September 17, 2018
US government releases the latest statistics on substance trends, revealing an overall drop in opioid misuse.

Results from the 2017 National Survey on Drug Use and Health (NSDUH) were released by SAMHSA last Friday, September 14. In addition to reporting on substance use, suicide, and mental illness with a sample size of 67,500, the annual national report included details on opioid use and addiction between 2016 and 2017, and from 2002 to 2017.

Misuse of opioids—both prescription and illicit—within the past year among those aged 12 or older stood at 11.4 million, of which 769,000 were among youth (age 12 to 17), marking an approximate 1% drop from the 11.8 million misusers cited in the 2016 national trend report. In the new data, 886,000 cases of opioid misuse were tied to heroin specifically—marking a rise in heroin use compared to 2002-2011 trends, but similar usage compared to 2012-2015 trends. Specifically, about 475,000 were heroin users in 2016, or 0.2% of the US population, while the 2017 data revealed a slight drop to 474,000 users.

With regard to prescription pain reliever misuse, among those age 12 and older, in 2017, the number was 3.2 million compared to 3.3 million in 2016.

According to the NSDUH report. “In 2017, hydrocodone products were the most commonly misused subtype of prescription pain relievers, including Vicodin, Lortab, Norco, Zohydro ER, and generic hydrocodone.” An estimated 6.3 million people aged 12 or older misused hydrocodone products while an estimated 3.7 million people misused oxycodone products, such as OxyContin, Percocet, Percodan, Roxicodon, and generic oxycodone. An estimated 0.3% misused buprenorphine products; just over 260,000 (0.1%) misused methadone and 245,000 misused prescription fentanyl (also 0.1%).

Primary reasons reported by survey participants for misuse included the following, with pain topping the chart:

  • to relieve physical pain (62.6%)
  • to feel good or get high (13.2%)
  • to relax or relieve tension (8.4%).

“Less common reasons among past year misusers of pain relievers included to help with sleep (5.4%), to help with feelings or emotions (3.6%), to experiment or see what the drug was like (2.8%), because they were ‘hooked’ or needed to have the drug (2.2%), and to increase or decrease the effects of other drugs0 (07%),” according to the report.

The majority of the misused prescription pain relievers seemed to come from “a friend or relative” at approximately 53% and while 36.6% were obtained from a healthcare provider.

AMA Response

Despite the positive trends, the American Medical Association (AMA) put out a statement September 17, noting that the survey also found "major gaps in treatment for those with a substance use disorder or with a mental illness. The AMA is particularly troubled by the fact that suicidal thoughts and plans for suicide are higher for those with a substance use disorder compared to those who do not have a substance use disorder." The association called for the need to increase high-quality, evidence-based treatment for these disorders. In the same week that the NSDUH survey results were released, for example, NPR issued a report regarding how many opioid use disorder recovery centers do not permit the use of medication-assisted treatment (MAT).

 

See also, the AMA position on physician burnout in pain practice.

Last updated on: September 17, 2018
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