A new study by one of the nation’s largest drug screening companies suggests that the misuse of opioid pain medicines and other prescription drugs may be declining in the United States.
In an analysis of over 1.4 million urine drug tests, the Quest Diagnostics Health Trends study found that the number of patients misusing their medications fell from 63% in 2011 to 55% in 2013.
Drug misuse rates were greater than 50% for both men and women, and for all age groups except patients over the age of 64.
“Prescription drug misuse remains at alarming levels, with more than one in two patients putting their health at risk through inappropriate and potentially dangerous misuse of drug therapies,” said F. Leland McClure, PhD, a study investigator for Quest Diagnostics (NYSE: DGX).
“But the multi-year analysis yielded some positive findings, including significant decreases in certain states with comprehensive prescription drug abuse programs. These findings indicate that, armed with the right strategies and tools, policymakers and health professionals are making headway against the prescription drug epidemic.”
Five states that cracked down on “pill mills” or implemented prescription drug abuse prevention and monitoring programs (PDMPs) showed the highest rates of decline in drug misuse. Florida, Georgia, Kentucky, New York and Tennessee had an average decline of 10.7% in prescription drug misuse, nearly 2.5 times higher than the average decline for all other states combined.
Patients in the Quest study were screened for up to 26 commonly prescribed and abused drugs, including opioid pain medications, central nervous system medications, and amphetamines, as well as some illicit drugs such as marijuana, cocaine, and heroin.
Drug misuse was very broadly defined in the study and includes “inconsistent” results – such as a patient not taking a drug that was prescribed for them. In 2013, no drugs were found in 43% of the inconsistent cases, an increase from 40% in 2011.
“Many patients do not take their prescribed drugs. Patients may cease taking a prescription due to a concern of side effects or because their pain had subsided,” the Quest report states. “Others may not take their drugs perhaps due to financial constraints or through sale of their medication.”
The report does not mention that many pain patients, particularly in states such as Florida, have difficulty getting their opioid prescriptions filled at pharmacies.
“Healthcare practitioners need to know that their patients are not following their instructions,” said Michael R. Clark, MD, associate professor and director, Chronic Pain Treatment Program, Department of Psychiatry and Behavioral Sciences, The Johns Hopkins Hospital.
“While inconsistency rates have decreased over time, patients are still substituting, supplementing, and diverting their prescribed controlled substances. In fact, over recent years, patients are supplementing their prescribed medications with increasing amounts of non-prescribed substances.”
The study’s findings support research released earlier this month by the Centers for Disease Control and Prevention (CDC), which found a 23% decrease in drug overdose deaths in Florida between 2010 and 2012, with similar improvements in New York and Tennessee.
Opioid prescribing rates remain very high in Tennessee and Kentucky, according to the CDC.
“Certain states have taken to heart the need to address prescription drug abuse, with proactive measures that involve physician and patient education as well as PDMPs and appropriate testing,” said Harvey W. Kaufman, MD, a study investigator and senior medical director, Quest Diagnostics.
“Prescription drug medications such as opioids and amphetamines can be enormously effective therapies, and for many people a source of better health outcomes, such as reduced pain. We need to find a balance between ensuring patients get the medications they need and preventing them from developing addiction and other health problems. Greater public education of the dangers of inappropriate prescription drug use is critical in this effort.”