Research from the medical data firm IMS Health suggests that opioid drug prescriptions have decreased for the first time in two decades. Although the decline likely stems from a heightened awareness of their dangers in the medical world, it also creates a demand for alternative drugs, which has lead to an increase in fatal overdoses.
"The urgency of the epidemic, its devastating consequences, demands interventions that in some instances may make it harder for some patients to get their medication," said Nora Volkow, the director of the National Institute on Drug Abuse. "We need to set up a system to make sure they are covered. But we cannot continue the prescription practice of opioids the way we have been. We just can't."
The IMS Health data reveals that there has been a 12 percent decrease in opioid prescriptions since 2012, while another medical data firm found an 18 percent decrease during the same time period.
Despite the decrease in opioid prescriptions, the new research also found an 8.5 percent increase in prescription drug spending in the United Sates, a finding that experts suggest stems from drugs that act as alternatives to opioids, such as gabapentin.
"When I was a resident, treating patients' pain as a vital sign was assumed," said Branson Page, an emergency medicine doctor at Granville Medical Center. "Now, more of us are aware that even prescribing a small number of opioids to a patient who's never taken them before is rolling the dice on whether that patient will become addicted."
Even more worrying is the fact that although less opioid drugs are being prescribed, fatal overdoses from prescription painkillers have increased. In 2014, more than 28,000 people died from overdoses from these drugs, and around 19,000 of these deaths are believed to be due to opioids.
"What is most striking is that the number of unintentional overdoses are still climbing despite fewer pills being described," said Lynn Webster, former president of the American Academy of Pain Medicine. "Obviously this is a reflection that the goal to reduce harm from reduced prescribing is not working. We have to wait to see if that trend continues."
The rise in deaths associated with prescription painkillers suggests that addicts losing out on prescriptions are turning to street drugs such as heroin, which is stronger than prescribed medication and can sometimes be easier to obtain as well.
The research will be presented by IMS Health at the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) 21st Annual International Meeting.
