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.