By Dr. Gina Jabbour
Deaths from prescription painkillers such as Vicodin and OxyContin nearly quadrupled between 1999 and 2011, according to statistics released today by the U.S. Centers for Disease Control and Prevention.
In 1999, there were 4,263 deaths linked to opioid drugs but, by 2011, the number had climbed to nearly 17,000, the researchers found, adding that it likely climbed even higher.
"The numbers we're seeing are definite underestimates," said Dr. Holly Hedegaard, injury epidemiologist at the National Center for Health Statistics and one of the lead authors of the CDC report. The researchers used death certificates to conduct their research, but specific drugs weren't named in about 25 percent of drug poisoning deaths, Hedegaard said.
Her team found that the problem goes beyond opioid pain drugs alone. According to the new CDC report, the number of deaths linked to a combination of opioids with benzodiazepine drugs, like Xanax or Klonopin, was also on the rise. In 2011, nearly a third of opioid related deaths occurred in combination with benzodiazepines - a considerable jump from only about 13 percent in 1999.
The report also concluded that the group that saw the greatest increase in death rates was Americans between 55 and 65 years old.
"This is not the typical age group that you would associate drug use with," said Dr. Robert Waldman, an addiction medicine consultant not involved with the research. "These are people that have pain medicine via a prescription."
Over the past decade, Waldman said, the medical community has begun to place more emphasis on treating pain symptoms. While this has led to relief for many experiencing such symptoms, he said, it may have also led to more aggressive treatment of pain - and with it, more use of prescription painkillers.
"The amount that [opioids] are administered by well-meaning physicians is excessive," he said. "Most physicians are people-pleasers who want to help and want to meet people's needs, and they are more inclined to give people the benefit of the doubt until you are shown otherwise."
Still, the rise in deaths at least appears to be slowing down in younger age groups. Signs of this plateau were first seen in 2006 in the 15-24 age group. Around that same time, the rise in deaths started to slow in other age groups, as well - likely due to a combination of increasing drug awareness, law enforcement activities and drug treatment programs.
Waldman said those approaches may be the best hope of tackling the opioid problem, along with strategies like prescription monitoring programs, limiting the number of pills dispensed, and requiring hard copies of prescriptions for opioids rather than allowing patients to call in for refills.
"Opioids are a last resort and should be used when nothing else works," Waldman said. "All they do is provide symptomatic relief without relieving the underlying cause of the pain."
When people hear that drugs, in general, accounted for 90 percent of injury-related deaths in 2011, the temptation is to think of illicit substances such as heroin and cocaine. But it is becoming increasingly obvious that opioids prescribed by doctors are to blame, too.
The numbers released by the CDC remind us that even the most common painkillers can have serious consequences. The report shows the opioid problem permeates all age groups, and everyone needs to be educated on the risks of opioids.
The important thing to remember is that everyone has a part to play. Parents should talk to their kids - and even their parents - about the risks of opioids. Schools should refocus their drug education efforts, and doctors must emphasize these risks during patient appointments. All of these conversations need to get louder. The message that opioids are addictive and dangerous needs to be heard.