Oxycodone: Usage trends
Last modified: Saturday, 20. June 2009 - 2:33 pm
Scope and severity
National surveys have shown that abuse of prescription drugs is on the rise in the United States. Compared with the 1980s, when fewer than 500,000 people took a prescription drug for a nonmedical reason each year, the number of people who engaged in this behavior increased 181% from 1990 to 1998 for pain relievers alone.
In a Consensus Development Conference statement published in late 1997, the National Institutes of Health (NIH) estimated that approximately 600,000 people in the United States are opiate-dependent, meaning they use an opiate drug daily or on a frequent basis.
The DEA says oxycodone and hydrocodone are among the most abused of the prescription painkillers. An increasing number of people who abuse these drugs are requiring medical attention because of side effects, overdose, and other issues that arise when the drugs are used for reasons other than their intended purpose. Statistics compiled by the Drug Abuse Warning Network (DAWN) indicate that oxycodone-related visits to hospital emergency departments are increasing steadily. In 2000, the number of such visits was 10,825 per year, more than double the 5,211 visits reported just two years earlier.
The number of prescriptions written for oxycodone combination drugs increased slightly during the period from 1996-2000. However, the DEA’s Diversion Control Program found that the number of prescriptions written for oxycodone-only drugs such as OxyContin was 14 times higher during the same time period.
According to a national study undertaken by the DEA, 803 deaths in 31 states in 2000 and 2001 were related to use of oxycodone and another 179 deaths were likely related to oxycodone. Of the 803 total deaths related to the drug, 117 were linked specifically to OxyContin. The study was undertaken in the form of letters sent to 775 medical examiners (MEs). The MEs were asked to supply autopsy reports, blood, and drug test results, and to investigate reports on all deaths caused by or associated with use of oxycodone.
Age, ethnic, and gender trends
NIDA data from 1999 show an estimated four million Americans over age 12 were using prescription pain relievers, sedatives, and stimulants for nonmedical reasons. Nearly 50% of those were first-time users. For the most part, young people appear to be the leading new and first-time users, according to data from the National Household Survey on Drug Abuse (1999). The most dramatic increase in new users of prescription drugs for nonmedical reasons occurred among 12- to 25-year-olds. The same data show that nonmedical use of two pain relievers — oxycodone with aspirin (Percodan) and hydrocodone (Vicodin) — is increasing among college students.
NIDA statistics also indicate that adolescent girls are abusing prescriptions more than ever before and are engaging in illicit drug use to a greater extent than their male peers. Opioids are the prescription drugs most likely to be abused by young people, followed by central nervous system depressants such as Valium and Xanax, and stimulants such as Ritalin.
Among adults, some studies suggest that women are more likely than men to be prescribed the more highly abused drugs, including painkillers and anti-anxiety medications. In fact, some studies have shown that women may be as much as 48% more likely than men to be given these drugs. The studies also indicate, according to NIDA, that women and men who use prescription opioids run an equal risk of becoming addicted. Women run a much higher risk than men of becoming addicted to other drugs, though, particularly sedatives, anti-anxiety medications, and hypnotic drugs such as sleeping pills.
Pain is a common problem in the elderly, and many elderly people are prescribed painkillers. A report from the American Geriatrics Society found that about one-fourth to one-half of all elderly people not living in nursing homes report pain-related problems, and one in five people over age 65 take painkillers one or more times each week. As many as three in five elderly people have taken prescription pain medication for more than six months. In nursing homes or other care facilities, as many as 80% of elderly patients report some type of pain.
Misuse of prescription drugs, including painkillers, is common among elderly people. However, unlike with younger people, when elderly people misuse or abuse prescriptions it is more likely to be accidental or unintentional. Since the body’s ability to metabolize, or break down, many medications decreases with age, elderly people usually are prescribed lower doses of potent drugs than younger persons are.
Another group that is potentially at increased risk for abuse of painkillers is doctors, nurses, pharmacists, anesthesiologists, dentists, veterinarians, and others who work in health care. It may be easier for people working in environments where drugs are kept or dispensed to either steal pills or forge prescriptions for themselves or others.
People who abuse prescription drugs may escape detection for years because they have learned how to “beat the system” and obtain prescriptions by visiting different doctors and claiming a different ailment at each place. In addition, some doctors may have trouble saying no to patients asking for prescription pain medication for fear that the patients may truly be in pain. Meanwhile, others simply do not realize they are being tricked by patients with a serious drug problem. The Substance Abuse and Mental Health Services Administration (SAMSHA) began a major training program in 2000 to help doctors, nurses, and others spot signs of drug abuse in patients. If they know how to recognize the signs, health professionals can then talk to patients about the problem and refer them for appropriate treatment.