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Long-term Painkiller Use on the Rise, More Patients Taking Dangerous Combos Says New Study
Although the total number of Americans taking prescription opioid painkillers has gone down a little over the past 5 years, those taking the drugs are taking more of them in higher doses and for longer periods of time, says a new study.
Complicating this situation is an even more dangerous practice: More people than ever are taking dangerous combinations – usually anti-anxiety benzodiazapines like Xanax – with their painkillers. Like opioids, these other drugs also depress the central nervous system, adding to the potential for an overdose. The most common overdose deaths attributed to drug combinations are opioids mixed with anti-anxiety drugs like Xanax.
The study, by pharmacy insurance benefits managers Express Scripts, reveals why there has been an increase in abuse, dependencies, addictions and overdoses in spite of the fact that fewer people are taking opioids. (Express Scripts oversees more than a billion prescriptions each year for tens of millions of patients.)
Express Scripts examined more than 36 million pharmacy insurance claims from 6.8 million insured Americans of all ages who filled at least one prescription for an opioid between 2009 through 2013.
The study included prescriptions to treat both short term and long term pain situations. Short-term users were “patients who were prescribed an opiate pain medication for a total supply of 30 days or less within a one-year period.” Long-term users were defined as “those prescribed an opiate pain medication for more than a 30-day supply in a one-year period.”
The study found that:
- 33 percent of patients were on an opiate and a benzodiazepine, the most common cause of multiple-drug overdose deaths
- 27 percent of patients were taking multiple opiate painkillers simultaneously
- 28 percent of patients were taking both a prescription opioid and a muscle relaxant
- 8 percent were combining an opioid, muscle relaxant and a benzodiazepine.
Opioids, muscle relaxants and benzodiazepines all slow down the respiratory system, exponentially increasing the risk of death.
Here are some of the more instructive highlights from the study, covering the five years of 2009 through 2013:
Fewer patients but more prescriptions
The number of people filling prescriptions went down 9.2 percent, but the number of prescriptions filled and the number of days taking the drugs rose approximately 8.4 percent.
Most long-term users take dangerous combinations
Nearly 60 percent of patients using opioids were taking a dangerous, potentially fatal combination of drugs; and one in three were prescribed anti-anxiety drugs (benzodiazepines) along with the opioid. And in many cases, if not most, it’s difficult to justify these combination prescriptions.
Short-term use declined, but long term did not
While the number of short-term opioid users declined 11.1 percent, long-term opioid users remained level (see the graph below).
More long-term users taking short-acting meds
Nearly half of all patients who took painkillers for more than 30 days during their first year of use continued to use them for three years or longer. And almost half of those patients were taking only short-acting opioids, a practice known to raise the risk of addiction.
Younger adults use more painkillers
Although more elderly Americans use opioid painkillers, younger adults (20 – 44) filled more prescriptions, and had the greatest increase in the number of days prescribed per prescription, of any age group over the five year period.
Women take more opioid painkillers than men
30 percent more women than men took opioid painkillers in 2013. However, men were more likely to fill more prescriptions and take higher doses.
Painkiller prescriptions most prescribed in small Southeastern cities
The greatest concentration of opioid painkillers was found in the smaller cities in the Southeast, the vast majority in Kentucky, Alabama, Georgia and Arkansas.
What we can learn from this is simple: we’re taking too many dangerous drugs, and doctors shouldn’t be prescribing this many drugs in these combinations. America has less than 5 percent of the world’s population, yet we consume roughly 80 percent of the world’s opioid supply.
It’s time we start reminding ourselves and our loved ones that there are other ways to treat simple pain, ways that are far less dangerous than powerful and addictive opioids. And if we are forced to take them, stay away from those risky combinations.
Bottom line is, opioids, especially combined with other drugs and with alcohol, are a tight-rope walk across the Grand Canyon without a net. If you or someone you care for is on that tight-rope, call Novus today. We’re always here to help.
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