Opioid overprescribing continues at high rates for the vulnerable


Growing evidence indicates that doctors are still overprescribing drugs at dangerous rates to people with a high risk of substance use disorder, a new report on opioid addiction found.

Conducted by the University of Maryland School of Public Health and the Hazelden Betty Ford Institute, the research also revealed that 50 percent of those who survive an opioid overdose in 2016 had past issues with other drugs or alcohol — but the majority, 75 percent, experienced accidental overdose because of polysubstance use.

“Imagine the city of Portland, Oregon. Now, imagine it’s gone. Just since 1999, more than 625,000 American lives have been lost to drug overdose,” said Jeremiah Gardner, manager of the Hazelden Betty Ford Institute for Recovery Advocacy, a part of the Hazelden Betty Ford Foundation.

“Even for those of us immersed in the issue for years, that number is staggering,” he added.  “Believe it or not, that’s nearly as many people as we’ve had killed in all of the wars in the United States’ 240-year history. Those numbers, by the way, represent only drug overdoses. They don’t even include the 90,000 who die every year from alcohol-related causes. Nor do they represent the millions of other lives negatively impacted by the use of alcohol and other drugs.”

The paper noted that currently there is a two- to a three-year delay between when a fatal opioid overdose occurs and when it’s documented in the national data systems. Among young adults who used heroin within the past 30 days, 97 percent also engaged in tobacco use, 89 percent drank alcohol, and 82 percent smoked cannabis.

In 2014, about 90 percent of people accepted into addiction treatment primarily because of an opioid use disorder also suffered from another type of drug addiction when they were admitted; and 21 percent of opioid overdoses were linked to the simultaneous use of alcohol while one-third were linked to the concurrent use of benzodiazepines — an anti-anxiety drug.

“Unfortunately, the problem continues to expand faster than our solutions. Much more needs to be done,” Gardner said.

The report offered various approaches that might slow down the opioid epidemic:

  • The education system would benefit from establishing a guideline to identify youth who may be engaged in drug use and also advise to the attend intervention programs.
  • Health care practitioners who approve opioid prescriptions should thoroughly screen a patient’s history of drug use and cautiously monitor all potential signs of dependence.
  • Those with opioid addictions should be given comprehensive and accessible long-term treatment that tackles all forms of drug use.
  • Systems that track data and provide real-time surveillance of fatal opioid overdoses should be developed to evaluate policies and programs that will be or are already in place to fight the opioid epidemic.

It’s also necessary to understand how creating effective strategies will fit into the wider context of drug use behaviors, the researcher added. For example, since studies have revealed that most people with opioid use disorders also use other substances, they must participate in long-term, comprehensive addiction treatment. Also, considering the significant overlap between prescription drug misuse and drug and alcohol use, efforts and resources aimed at preventing drug use among youth can assist in slowing down the opioid crisis.

“The opioid epidemic has taken our national addiction crisis to an unprecedented level of devastation, with enormous human and financial costs to individuals, families and communities,” Gardner said. “We also know this is a crisis that will demand our continued attention and long-term commitment.”