Hydromorphone: Usage trends

Last modified: Sunday, 31. May 2009 - 4:19 pm

Scope and severity
Despite worry over the potential for addiction, opioid use for medical purposes has been increasing in recent years for most narcotic analgesics. However, despite the overall increase in the use of opioids for legitimate medical reasons, drug abuse among legitimate users has fallen during this period of time.
Evidence gathered from surveys in the United States suggest prescription drug abuse is increasing. In these surveys, prescription drug abuse in the 1980s was compared with trends in the 1990s. During the 1980s, researchers estimated that less than one-half million persons abused prescription drugs. However, this number increased by 181% between 1990 and 1998 among pain-relieving drugs.
Evidence collected by the National Institute on Drug Abuse (NIDA) during 1999 suggests more than four million persons in the United States over the age of 12 years were using a variety of prescription drugs for nonmedical purposes. Many of these individuals were first-time users of these drugs. Most of the first-time users were between 12 and 25 years of age.
Statistics gathered by NIDA indicate that prescription drug abuse among girls is significantly increasing. Overall, girls are using illicit drugs at a higher rate than boys in the same age groups. The prescription drugs most likely to be abused by young people of both sexes are opioids. Tranquilizers and stimulants are also highly abused by many young people.
Women are more likely than men to receive prescribed drugs that are abused among adult populations. These prescribed drugs are most often antidepressants and pain relievers. Evidence indicates that men and women are at similar risk for becoming addicted to opioids. However, women are far more likely to become addicted to other types of prescription drugs than men.
The use of pain relievers is also significant in the elderly; it is well-known that pain is a widespread problem in this age group. Up to one-half of the elderly not living in nursing homes are affected by pain on a regular basis. The American Geriatrics Society also reports that as many as 20% of those over the age of 65 years use prescription pain relievers at least once per week. Furthermore, about 60% of the elderly have taken some type of prescription pain reliever for a minimum of six months. In nursing homes, these rates are even higher.
The elderly need greater attention when they receive strong pain-relieving drugs, such as opioids. This is based on the fact that elderly patients are more likely to accidentally misuse prescription drugs than the general population. They are more likely to inaccurately read drug labels and to not follow health-care provider instructions. Generally, the elderly need lower doses of drugs, especially potent drugs, than the general population.
Another area of concern in prescription drug abuse is with health-care providers, such as nurses, doctors, pharmacists, dentists, and others. These persons have ready access to highly addictive drugs, such as the opioids, and are more vulnerable to such abuse. In addition, these professions are more stressful than average, and this may be a factor in the higher-than-normal rates of abuse in this group.
Many drug abusers have developed elaborate schemes for obtaining prescription drugs for nonmedical purposes. They are often able to successfully dupe physicians into prescribing drugs, such as opioids, for recreational drug use. Many physicians believe these individuals are in pain and need relief. Organizations such as the Substance Abuse and Mental Health Services Administration are attempting to educate physicians about the warning sign behaviors associated with these abusers.
Age, ethnic, and gender trends
According to a report commissioned by the Texas Commission on Alcohol and Drug Abuse, adult clients who were admitted to a heroin inhalation addiction treatment program in 1998 tended to be male (65%), African-American (36%), and low-income (average yearly income $6,784). This fits with data collected from opiate addicts from other parts of the country. Researchers also know that hydromorphone, when available on the street, is commonly substituted for heroin. However, it is also known that women are much more likely to abuse prescription drugs than men, but men are much more likely to abuse the illicit forms of drugs, including opiates. Abuse of opiates, like abuse of most all other drugs, is mostly carried out by younger persons, but this is not always the case.

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