Deadly epidemic: Prescription drug overdoses
A growing epidemic of overdoses of prescription painkillers is leading to a record numbers of deaths, especially among women, according to the Centers for Disease Control and Prevention.
"More women are dying at rates that we have never seen before," CDC Director Dr. Thomas Frieden said about the findings, which were released earlier this month.
"Stopping this epidemic in women—and men—is everyone's business," Frieden added.
More Americans now die from painkillers than from heroin and cocaine combined, and since 2008, prescription drug-induced deaths have outstripped those from automobil accidents, according to the CDC.
The CDC's latest figures show that 16,500 people died from overdoses tied to common narcotic pain relievers—such as Vicodin, OxyContin, Opana and methadone—in 2010. Forty percent of those were women.
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In the past 11 years, deaths from overdose increased more than 400 percent among women, compared with a 265 percent rise among men.
"It's not surprising with the greater access to medical procedures, like surgeries for knees, backs and hips," said Kent Runyon, director of Novus Medical Detox, a prescription drug private rehab center in New Port Rickey, Fla.
"Patients get prescriptions for pain drugs and then they get addicted, making it very hard to get off them," he said.
"Her life was a mess. ..."
"We had a woman here recently who sang in the church choir, was a stay-at-home mom, had beautiful children and a businessman husband," Runyon said. "She had back surgery, which led her to prescription drugs for the pain. And when she turned to alcohol, her life was a mess."
Americans consume 80 percent of opiate painkillers produced in the world, according to the American Society of Interventional Pain Physicians. Every hour, a baby is born in the United States with symptoms of opiate withdrawal, according to a study published in April by the Journal of the American Medical Association.
"I think it's our culture," Runyon said. "We are so oriented to finding easy solutions to problems, prescription drugs have become part of those solutions."
A record 4.02 billion drug prescriptions were written in the U.S. in 2011, up from 3.99 billion the year before, according to the journal ACS Chemical Neuroscience.
Antidepressants such as Zoloft and Celexa were the most prescribed class of drugs in 2011, with 264 million prescriptions filled. Slightly more than 131 million prescriptions were written for generic Vicodin.
Some 31.9 million prescriptions were written for generic Percocet, while 29.3 million were were written for generic Neurontin, which is frequently prescribed to manage long-term pain.
With so many prescriptions flowing from doctors, they might be an easy target for blame, as well as the pharmaceutical companies that make the drugs.
In the $600 billion worldwide pharmaceutical industry, for every dollar a company spends on "basic research," it puts $19 toward promotion and marketing, according to a report last year by BMJ, a London based medical journal.
"Manufacturers and prescribers have overestimated the benefits of these drugs," said Dr. Leonard Paulozzi, an overdose expert at the CDC. "The risks from these drugs were thought to be small for noncancer pain, but they are substantial," he added.
Runyon says it's hard to point to any one cause.
"A lot of patients don't ask about medications, and doctors might assume people know what they're getting into when taking the drugs," Runyon said. "There's no strategy on either side to get off them."
Calls to AbbVie Pharmaceuticals, a major producer of Vicodin (hydrocodone bitartrate and acetaminophen) were not returned.
Purdue Pharma, which makes OxyContin (oxycodone HCl controlled-release) tablets issued these comments in a reply to email questions:
"OxyContin prescriptions represent a very small share of the total opioid market (e.g., the volume of OxyContin prescriptions has never exceeded 4.4 percent of the total number of prescriptions written for opioid pain medications). In fact, our market share has declined since 2001.
"Studies and reports from medical examiners have shown that the vast majority of overdose deaths involving oxycodone, the active ingredient in OxyContin, Percocet and many generic pain medications, are caused by ingestion of multiple drugs, often in combination with alcohol.
"Purdue consistently provides information to healthcare professionals to encourage the appropriate use of OxyContin. The product's labeling has always included clear warnings about the potential for abuse and overdose.
"We are committed to working with healthcare professionals, law enforcement and the government to reduce the abuse of, and overdoses involving, prescription pain medications."
Efforts to control epidemic
In an attempt to stem prescription drug abuse, an advisory panel to the Food and Drug Administration voted in January to toughen restrictions on painkillers, such as Vicodin, containing hydrocodone.
The recommendation would limit access to the drugs by making them harder to prescribe. The FDA has not applied the restrictions.
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The CDC has called for several steps, including "better tracking of prescription overdose trends to better understand the epidemic," as well as urging patients to discuss their medications with their doctors and talk about pain treatment plans that exclude prescription drugs.
Americans may finally—if slowly—be catching on to the dangers. Prescription drug spending last year fell to $325.8 billion from $329.2 billion in 2011. That's the first drop in spending in the last 58 years, according to the IMS Institute for Healthcare Informatics.
"There are some encouraging steps that some deaths in certain states are falling for reasons unknown, but overall I don't think we'll see a decline when we get to 2012 numbers," said the CDC's Paulozzi.
Some 45 deaths from prescription drug overdose are recorded daily in the U.S.—quadruple the number in 1999, according to the CDC.
Until more people in pain realize what they're getting into with prescription drugs, the situation will only get worse, said Runyon.
"We've had to turn away patients because we don't have the room," said Runyon. His center holds 12 patients, nine of whom are being treated for prescription drug addiction.
"We're expanding our facilities to 31 beds because we know we have to," he said.