Prescription Painkiller Overdoses in the U.S.

Overdoses involving prescription painkillers—a class of drugs that includes hydrocodone, methadone, oxycodone, and oxymorphone—are a public health epidemic. These drugs are widely misused and abused. One in 20 people in the United States, ages 12 and older, used prescription painkillers nonmedically (without a prescription or just for the "high" they cause) in 2010. A recent CDC analysis discusses this growing epidemic and suggested measures for prevention.

A Public Health Epidemic

The problem of prescription painkiller overdoses has reached epidemic proportions.
Consider that:

Prescription painkiller overdoses killed nearly 15,000 people in the US in 2008. This is more than 3 times the 4,000 people killed by these drugs in 1999.
In 2010, about 12 million Americans (age 12 or older) reported nonmedical use of prescription painkillers in the past year.
Nearly half a million emergency department visits in 2009 were due to people misusing or abusing prescription painkillers.
Nonmedical use of prescription painkillers costs health insurers up to $72.5 billion annually in direct health care costs.

Groups at Greatest Risk

Certain groups are more likely to abuse or overdose on prescription painkillers:

Many more men than women die of overdoses from prescription painkillers.
Middle-aged adults have the highest prescription painkiller overdose rates.
People in rural counties are about two times as likely to overdose on prescription painkillers as people in big cities.
Whites and American Indian or Alaska Natives are more likely to overdose on prescription painkillers.
About 1 in 10 American Indian or Alaska Natives age 12 or older used prescription painkillers for nonmedical reasons in the past year, compared to 1 in 20 whites and 1 in 30 blacks.

Steps for Safety
The Federal Government is:
Tracking prescription drug overdose trends to better understand the epidemic.
Working with stakeholder organizations to educate health care providers and the public about prescription drug abuse and overdose.
Evaluating and promoting programs and policies shown to prevent prescription drug overdose, while making sure patients have access to safe, effective pain treatment.
There are steps that everyone can take to help prevent overdoses involving prescription painkillers, while making sure patients have access to safe, effective treatment.

States can:
•Start or improve prescription drug monitoring programs (PDMPs), which are electronic databases that track all prescriptions for painkillers in the state.
•Use PDMP, Medicaid, and workers' compensation data to identify improper prescribing of painkillers.
•Set up programs for Medicaid, workers' compensation programs, and state-run health plans that identify and address improper patient use of painkillers.
•Pass, enforce and evaluate pill mill, doctor shopping and other laws to reduce prescription painkiller abuse.
•Encourage professional licensing boards to take action against inappropriate prescribing.
•Increase access to substance abuse treatment.

Individuals can:
•Use prescription painkillers only as directed by a health care provider.
•Make sure they are the only one to use their prescription painkillers. Not selling or sharing them with others helps prevent misuse and abuse.
•Store prescription painkillers in a secure place and dispose of them properly.*
•Get help for substance abuse problems if needed (1-800-662-HELP).

Health insurers can:
•Set up prescription claims review programs to identify and address improper prescribing and use of painkillers.
•Increase coverage for other treatments to reduce pain, such as physical therapy, and for substance abuse treatment.

Health care providers can:
•Follow guidelines for responsible painkiller prescribing, including
◦Screening and monitoring for substance abuse and mental health problems.
◦Prescribing painkillers only when other treatments have not been effective for pain.
◦Prescribing only the quantity of painkillers needed based on the expected length of pain.
◦Using patient-provider agreements combined with urine drug tests for people using prescription painkillers long term.
◦Talking with patients about safely using, storing and disposing of prescription painkillers.*
•Use PDMPs to identify patients who are improperly using prescription painkillers.
* Information on the proper storage and disposal of medications can be found at www.cdc.gov/HomeandRecreationalSafety/Poisoning/preventiontips.htm.