The use of prescription opioids, as well as heroin, have reached crisis levels throughout the United States. It is now commonly described as the ‘opioid epidemic’ as a large number of people have been diagnosed with one form of opioid use disorder or the other.

Even though the rate of abuse of opioids are often focused on the illegal, common street drugs like heroin and the misuse of opioid pain relievers, the fact is there is a worrying and growing number of people who misuse opioid analgesic medication as prescribed by their healthcare providers.

The Rising Frequency of Prescribed Opioid Painkillers

• In 2010 a study of the opioid prescription rates in the United States revealed that the percentage of Americans with an active opioid prescription rose from 7.4% in 2000 to 11.8%. This was a 104% rise in the prescription rates over this ten year period.
• In 2012, the national opioid prescription rate reached its peak after a steady rise from 2006, as more than 255 million people filled opioid prescriptions.
• The opioid prescriptions for children have remarkably been stable barely increasing from 2.68% in 1996 to 2.91% in 2012. The same cannot be said for adults whose prescription has remained extremely high over the past 15 years.
• In 2013, a study of eight states (California, Florida, Maine, Idaho, Delaware, Louisiana, Ohio and West Virginia) revealed that opioid prescription by medical professionals was twice the rate of other stimulants or benzodiazepines. Also, some patients were prescribed some opioid pain medications as well as benzodiazepines even though they faced the risk of taking both at the same time.
• About two million Americans, from 12 years and above either abused prescription opioids or were dependent on them in 2014.
• From 2012 to 2016 there was a steady decline in the opioid prescription rates. 2016 recorded the lowest rates in over a decade as just 214 million national total opioid prescriptions were filled.
• Sadly, 2016 also marked an increase in the opioid prescribing rate across the United States.
• Even though the overall opioid prescription rate fell to 66.5 prescriptions per 100 people in 2016, some counties reported rates that were seven times higher than that.
• It was shockingly discovered that in some counties in the United States there was enough opioid prescription for everyone living there.
• An investigation into the prescription patterns has revealed that most opioid prescriptions are written by a fairly small number of health care practitioners who are usually in family medicine, internal medicine, general practice or midlevel practitioners. It was discovered that these practitioners were the high ‘’risk prescribers’ who wrote over 16 times more monthly prescription than other “Low risk” healthcare practitioners.

 

Common reasons opioids are prescribed

About 11% of adults battle with chronic pains and millions of Americans fill opioid prescription forms annually due to chronic pain.  In a study to examine the root reasons why people use opioid medication and subsequently abuse them, (Roger. D Weiss et.,al,  2014) made the following discoveries.

• About 80% of people who took opioids revealed that it was due to chronic pain, 49% with moderate pain took opioids for pain relief.
• Some participants in the study revealed that they initiated opioid use to sleep better and reduce anxiety.
• Those with chronic pain also revealed that avoiding withdrawal was also a reason for continuously taking opioids.
• The presence of co-occurring psychological disorders.

Reducing Opioid Prescriptions

With the obvious effect of the increasing rate of opioid prescription, many health care professionals and legislative agencies have commenced the implementation of strategies to reduce the harm to society.

In line with this, prescription drug monitoring programs (PDMPs) have been set up by some states with the sole purpose of monitoring individuals’ prescriptions for opioid and other potentially harmful substances. Consequently, health care providers have the opportunity to access an additional source of information about a patients’ risk for opioid misuse before writing a prescription.

An examination of the impact of PDMPs in Florida revealed that participants recorded reduced opioid prescription rates, especially among the high volume prescribers. PDMPs had better positive outcomes when health care providers accessed all of the patients’ medical history before giving a prescription for opioid analgesics instead of only checking the patient’s PDMPs data in cases where they were not sure of the patient’s claims.

Improving the method of opioid prescription via clinical practice guidelines will make it easier for patients to have access to safer chronic pain medications and effectively reduce the risk of patients developing opioid pain disorders, overdose, and death.

Improving the way opioids are prescribed through clinical practice guidelines can ensure patients have access to safer, more effective chronic pain treatment while reducing the risk of opioid use disorder, overdose, and death.