In a report released Tuesday, the Centers for Disease Control and Prevention exposes the intricate landscape of America’s deadly opioid addiction.
“When prescriptions [opioids] go up, deaths go up. When they go down, deaths go down,” CDC Director Thomas Frieden said on a media call ahead of the release. “Prescription drug overdose is epidemic in the United States. All too often, and in far too many communities, the treatment is becoming the problem,”
In the Vital Signs report, the CDC analyzed 2012 prescribing data collected from retail pharmacies in the United States by a commercial vendor. Here are some of the report’s main takeaways:
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The more opioid prescriptions, the more fatal opioid overdoses
In the U.S. there are 46 deaths from a prescription overdose per day. Opioid pain relievers were involved in 16,917 overdose deaths in 2011; in 31% of these deaths, benzodiazepine sedatives were also cited as contributing causes (CDC WONDER, unpublished data, 2014).
Overprescribing physicians are the blame
Health care providers wrote 259 million prescriptions for opioid painkillers in 2012—enough for every American adult to have their own bottle of the pills. Many states attribute this to for-profit pain clinics (nicknamed “pill mills”) that prescribe large quantities of painkillers to people who don’t need them medically. Overprescribing can cause many medical issues, and even death.
The South is perpetuating the problem
The 10 highest prescribing states are the in South. Among the states with the most painkiller prescriptions per person, Alabama, Tennessee, and West Virginia were the top three. One particularly stunning example that illustrates this in the report: 22 times as many prescriptions were written for oxymorphone (a specific type of painkiller) in Tennessee as were written in Minnesota.
But the rest of the country isn’t helping either
Among the next highest states are three in the Midwest—Ohio, Indiana, and Michigan—where the number of painkiller prescriptions falls into the highest category (96-143 per 100 people). The Northeast, especially Maine and New Hampshire, had the most prescriptions per person for long-acting and high-dose painkillers.
Prescription opioid abuse is fueling heroin addiction—and overdoses
“The heroin problem is serious and we see it getting worse in other parts of the country,” says the CDC. While prescription opiates kill twice as many people as heroin and cocaine combined, new studies suggest that 3 out of 4 people with a dependence on heroin began with prescription painkillers. “In some ways, it’s a single epidemic,” says Frieden.
State-run prescription drug-monitoring programs are a realistic solution
Combing the information of the entire state, these databases track prescriptions for painkillers and locate issues in overprescribing. Best practices for this method include making it available in real-time, making it universal (meaning its used by all prescribers for all controlled substances), and ensuring it’s actively managed (i.e. alerts immediately sent to prescribers).
Some states have tried them—and they’ve worked
In 2012, New York required prescribers to checks the state’s prescription drug monitoring program before prescribing painkillers. In 2013, the state saw a 75 percent decline in the number of patients obtaining painkillers from multiple subscribers. Florida, which began a pill mill crackdown in 2010, saw a 50 percent decrease in overdose deaths from oxycodone in 2012.
According to CDC Director Frieden, prescriptions have increased 400 percent in a decade, which has directly contributed to the number of deaths from these drugs. “Overdose rates are higher where these drugs are prescribed more frequently,” says Frieden. “States and practices where prescribing rates are highest need to take a particularly hard look at ways to reduce the inappropriate prescription of these dangerous drugs.”
