Prescription-Related Fatalities Skyrocket

813% Increase Since 1995

AP / Seattle Post-Intelligencer 5feb2007

SPOKANE — Deaths in Washington linked to prescription drugs such as hydrocodone and methadone increased by more than 800 percent in 10 years, according to new research.            

Painkillers resulted in 411 deaths in Washington in 2004, an 813 percent increase over the 45 deaths reported in 1995, state health researchers found. Spokane, with 48 deaths in 2004, had the highest death rate per population of any county in the state.

Health officials say the numbers speak to a nationwide problem. A national study drafted last year for the federal Centers for Disease Control and Prevention showed an increase of more than 91 percent in narcotic painkiller poisonings listed on death certificates between 1999 and 2002.

Unintended drug poisonings now account for almost as many deaths in Washington as car crashes — about 650 a year — primarily because of the spike in prescription-related fatalities, said Jennifer Sabel, an epidemiologist with the state Health Department.

"Prescription drug overdose deaths have been climbing through the roof," Sabel said. "Even doctors don't really realize the magnitude of the deaths."

In Washington, health officials are finding that legal opiates are killing more people than illicit substances, such as heroin.

"I've had to manually review all these death certificates and I've just seen it increase," said Ann Lima, a state epidemiologist trained to study causes of death.

Lima and a team of researchers examined more than 3,500 state death certificates from 1995 to 2004 that listed opiates as a cause.

They found that:

• Deaths linked to prescription drugs, illegal drugs or others that were unspecified more than doubled, from 260 to 555 a year.
• Deaths from prescribed opiates increased from 23 to 267.
• Deaths caused by heroin and other illicit opiates dropped 33 percent, from 215 in 1995 to 144 in 2004.

"In Spokane County, it has become much less usual to list heroin, cocaine and methamphetamine as the cause of death, and more common to find a prescription medication," Spokane County Medical Examiner Sally Aiken said.

The data have prompted some to start an advocacy group aimed at stopping teenagers from abusing prescription drugs. Public awareness needs to catch up with reality, said Mark Selle, a Chewelah-area school district superintendent who helped form the group Prescriptions for Life.

source: http://seattlepi.nwsource.com/local/302423_painkillers05.html 5feb2007

Prescription Narcotic Drug Use

excerpted from:
Health, United States, 2006
US Dept. Health & Human Services
Centers for Disease Control and Prevention
National Center for Health Statistics
p.80

The use of narcotic drugs among women has increased from 1988–1994 to 1999–2002, largely due to increased use among non-Hispanic white women and women age 45 years and over.

In recent decades, the medical community has increasingly recognized the importance of treating and controlling pain (1). The goal of pain management is to return patients to a pain level that allows them to function better in their daily lives. Pain may be managed by nonpharmacologic and pharmacologic means. Nonpharmacologic treatments include biofeedback, relaxation techniques, massage, and heat or cold application. These approaches usually supplement pharmacologic treatment (2). Pharmacologic approaches include a variety of medication options. Minor pain may be controlled by non-narcotic medications such as aspirin, acetaminophen, or ibuprofen. More severe pain may require the use of narcotic medications, such as codeine and oxycodone.

The National Health and Nutrition Examination Survey (NHANES) collects data on the prescription drug use of survey participants living in the community through in-person household interviews. Prescription drug use is determined by examining the prescription labels of the participant’s medications.

Between 1988–1994 and 1999–2002, the age-adjusted percentage of women reporting narcotic drug use in the month prior to interview increased by almost one-half from 3.6% to 5.3%. This increase was driven largely by an increase in narcotic drug use among women age 45 years and over (Figure 34). During this period, use of narcotic drugs rose by almost 75% among women 45–64 years of age to 5.7% and by more than 50% among women 65 years and over to 6.8%. This increased use has been primarily among non-Hispanic white women (data table for Figure 34 [Below]). In contrast, reported narcotic drug use among adult men remained stable from 1988–1994 to 1999–2002 and there were no significant differences in use for men by race or ethnicity.

In 1999–2002, women of all ages reported more narcotic drug use than men (Figure 34). Non-Hispanic white women were almost twice as likely to report narcotic use as women of Mexican origin (5.9% compared with 3.2%).

References

1. Phillips DM. JCAHO pain management standards are unveiled. JAMA 2000;284(4):428–9.

2. National Pharmaceutical Council, Inc. and Joint Commission on Accreditation of Healthcare Organizations. Pain: Current understanding of assessment, management, and treatments. Reston, VA: NPC; 2001.

Figure 34

Data table for Figure 34. Adults 18 years of age and over reporting narcotic drug use in the						
"month prior to interview, by sex, age, race and ethnicity:  United States, 1988-1994 and 1999-2002"						

	    1988-1994		    1999-2002			
						

	Percent	SE	Percent	SE		
						

Both sexes						

"Total, age adjusted "	3.2	0.2	4.2	0.3		
"Total, crude"	3.2	0.2	4.2	0.3		
						

  18-44 years	2.9	0.3	3.6	0.4		
  45-64 years	3.3	0.4	4.6	0.7		
  65 years and over	3.9	0.4	5.7	0.5		
						

Not Hispanic or Latino:					
  White only	3.4	0.3	4.6	0.4	
  Black or African American only	3.4	0.2	3.8	0.7	
Mexican	3.3	0.3	2.9	0.4	
					

Men					

"Total, age adjusted "	2.8	0.3	3.0	0.3	
"Total, crude"	2.7	0.3	3.0	0.3	
					

  18-44 years	2.4	0.4	2.5	0.4	
  45-64 years	3.3	0.6	*3.4	0.7	
  65 years and over	3.2	0.5	4.1	0.6	
					

Not Hispanic or Latino:					
  White only	2.9	0.4	3.3	0.4	
  Black or African American only	2.8	0.4	*2.9	0.7
Mexican	3.3	0.5	*2.7	0.6
				

Women				
				

"Total, age adjusted "	3.6	0.2	5.3	0.4
"Total, crude"	3.6	0.2	5.4	0.4
				

  18-44 years	3.5	0.3	4.6	0.6
  45-64 years	3.3	0.5	5.7	0.8
  65 years and over	4.4	0.5	6.8	0.9
				

Not Hispanic or Latino:				
  White only	3.8	0.3	5.9	0.5
  Black or African American only	3.8	0.5	4.5	0.8
Mexican	3.3	0.4	3.2	0.5
				

SE is standard error.				
				

*Estimates are considered unreliable. Data preceded by an asterisk have a relative standard				
error (RSE) of 20% to 30%. 				
				

NOTES: Data are for the civilian noninstitutionalized population.  Narcotic drugs are defined as drugs  				
in NDC class 1721. Estimates for 2000 and later years use weights				
derived from the 2000 census. Total and race-ethnicity estimates are age-adjusted to the				
"2000 standard population using three age groups: 18–44 years, 45–64 years, and 65 years and"				
"over. Persons of Mexican origin may be of any race. Starting with data year 1999,"				
race-specific estimates are tabulated according to the 1997 Revisions to the Standards for the Classification 				
"of Federal Data on Race and Ethnicity. See Appendix II, Age adjustment; Drugs; National Drug Code (NDC) Directory"				
therapeutic class; Hispanic origin; Race. 				
				

"SOURCE: Centers for Disease Control and Prevention, National Center for Health Statistics,"				
National Health and Nutrition Examination Survey.			
			

"Health, United States 2006"