U.S. Rx Painkiller Deaths Up

(WebMD)  Accidental deaths from prescription painkillers have risen in recent years in the U.S., show no signs of slowing down, and may be largely due to painkiller abuse.

The CDC's Leonard Paulozzi, MD, MPH, and colleagues, report the news in Pharmacoepidemiology and Drug Safety's online "Early View" edition.

Paulozzi's team checked CDC death certificate data on unintended deaths from opioid painkillers including oxycondone, hydrocodone, fentanyl, and methadone. Their findings:

Unintended prescription painkiller deaths rose 91% from 1999-2002.

Unintended deaths from heroin and cocaine rose by lesser amounts during the same period (about 12% for heroin and nearly 23% for cocaine).

The researchers write that in 2002, the latest year studied, "opioids were listed without cocaine or heroin in 4,451 deaths that year, more than the combined number of deaths listing either cocaine alone (2,569) or heroin alone (1,061)."

Drug Sales on the Rise

The rise in unintended prescription painkiller deaths mirrored an increase in sales of the drugs. The data also showed several clues about painkiller abuse.

For instance, men in their 40s accounted for many of the opioid deaths. And the background of people who accidentally died using prescription opioids matched those from other drug abuse deaths.

Those traits "do not match those of people who typically experience chronic pain, who are more likely to be female and older," the researchers write.

More steps may need to be taken to prevent painkiller abuse "without diminishing the quality of care for patients with a legitimate need for pain management," write Paulozzi and colleagues.

Painkiller abuse is a big problem, journal editorialists agree.

One editorial -- written by researchers including David Joranson, MSSW, of the University of Wisconsin at Madison -- calls for better data on painkiller abuse. The data Paulozzi's team used don't show which patients were abusing painkillers.

Another editorial -- written by Scott Fishman, MD, of the pain medicine division at the University of California, Davis – calls for aggressive action against painkiller abuse.

But drug abuse solutions "must not undermine patients in pain," Fishman writes. "The least we can do is make sure that the casualties of the war on drugs are not suffering patients who legitimately deserve relief," he adds.

SOURCES:: Paulozzi, L. Pharmacoepidemiology and Drug Safety, July 24, 2006; online "Early View" edition. Joranson, D. Pharmacoepidemiology and Drug Safety, July 24, 2006; online "Early View" edition. Fishman, S. Pharmacopepidemiology and Drug Safety, — July 24, 2006, online "Early View" edition. News release, John Wiley & Sons, Inc.


By Miranda Hitti
Reviewed by Louise Chang, M.D.
© 2006, WebMD Inc. All rights reserved