The CDC announced the 2009 National Youth Risk Behavior Survey (YRBS) found that 1 in 5 high school students have ever taken a prescription drug such as
OxyContin (oxycodone, from
Purdue),
Percocet (oxycodone/acetaminophen, from
Endo),
Vicodin (hydrocodone/acetaminophen, from
Abbott),
Adderall (mixed salts of a single-entity amphetamine product, from
Shire),
Ritalin (methylphenidate, from
Novartis), or
Xanax (alprazolam, from
Pfizer), without a prescription. Data from the Drug Abuse Warning Network show that in 2008, people 12–20 years of age accounted for an estimated 141,417 (14.5%) of the 971,914 emergency department visits for nonmedical use of pharmaceuticals, not including suicide attempts.
The new YRBS data plus the CDC's Injury Center's recently released issue brief “
Unintentional Drug Poisoning in the United States” highlight a serious public health problem with nonmedical use of prescription drugs. The issue brief points out that drug overdose rates have risen steadily since 1999, primarily due to prescription drugs. The “
Unintentional Drug Poisoning in the United States” issue brief recommends that healthcare providers:
- Use opioid medications for acute or chronic pain only after determining that alternative therapies do not deliver adequate pain relief. The lowest effective dose of opioids should be used.
- In addition to behavioral screening and use of patient contracts, consider random, periodic, targeted urine testing for opioids and other drugs for any patient <65 years old with noncancer pain who is being treated with opioids for >6 weeks.
- If a patient's dosage has increased to ≥120 morphine milligram equivalents per day without substantial improvement in pain and function, seek a consult from a pain specialist.
- Do not prescribe long-acting or controlled-release opioids for acute pain.
- Periodically request a report from your state prescription drug monitoring program on the prescribing of opioids to your patients by other providers.
For more information visit www.cdc.gov/media/pressrel/2010/s100603.htm.
Click here to view the
Clinicians' Guide to Management of Opioid Therapy.