Prescription Drug Overdose

The number of emergency room visits for overdoses related to abuse of prescription drugs doubled between 2004 and 2009. It now rivals the number of trips to the hospital caused by illicit drug use. Fatal poisonings from opioid and other prescription drug overdoses tripled to nearly 14,000 deaths from2004 to 2008, the Centers for Disease Control and Prevention reported in September 2009. The tally of near-deadly overdose incidents involving opioids and other prescription drugs is far higher and growing rapidly, as revealed in the CDC's June 18, 2009 Morbidity and Mortality Weekly Report. Availability and access to prescription drugs leads to misuse and abuse, and the opportunity of overdoses being that much greater. Emergency department visits related to misuse of prescription or over-the-counter drugs doubled from 500,000 in 2004 to over 1 million in 2009, said a report, and based on estimates from the Substance Abuse Services Administration's Drug Abuse Warning Network. DAWN generated these estimates by reviewing data and medical charts submitted by 231 U.S. emergency departments. These drugs are there for the taking in medicine cabinets across the country, and because of this, prescription drug overdoses are increasing. People seem to be more comfortable using prescription drugs than street drugs because they are prescribed by a doctor and approved by the FDA. But the logic isn't good, because the safety doesn't extend to their misuse, and overdoses of these prescription drugs is just as likely as with any illicit street drug.

Unintentional fatal prescription drug overdoses nearly doubled from 2004 to 2009 and were the second leading cause of accidental death in the United States in 2004, behind only automobile crashes, according to the Centers for Disease Control. Deaths from accidental overdoses increased to 29,838 in 2009, from 11,155 in2004, according to the CDC report, which was based on death certificate information (which does not detail which drugs were used). However, researchers believe the increasing misuse of prescription drugs by those ages 15 to 24 accounts for the majority of this statistic. Officially, drug overdose deaths are listed on death certificates as "poisoning." However, data from the National Vital Statistics System shows that drug poisoning accounted for 94.7 percent of all unintentional poisoning deaths by 2009.

The CDC attributes the 69.5 percent rise in drug overdose deaths between 2004 and 2009 to a higher use of prescription drugs, especially painkillers, and increasing numbers of overdoses of cocaine and prescription sedatives. The increase cannot be attributed to heroin, methamphetamines or other Illegal drugs such as cocaine and heroin were involved in 1 million emergency room trips annually a figure that stayed flat over the time period from last year. Opioids were the prescription drugs most likely to land users in the emergency department, accounting for an estimated 305,885 visits in 2009, more than double the 2006 estimate of 144,644. People who misuse opioids are vulnerable to respiratory depression and can become unresponsive quickly, experts said. They eventually may stop breathing and experience cardiac arrest."The misuse and abuse of long-acting and extended-release opioid drug products has resulted in a widespread and serious public health crisis of addiction, overdose and death," wrote Bob A. Rappaport, MD, director of the FDA Division of Anesthesia and Analgesia Products

According to the CDC report, these groups had the highest increases in deaths by drug overdose between 1999 and 2006:

  • Females - 103.0 percent
  • Whites - 75.8 percent
  • Persons in the southern United States - 113.6 percent
  • Persons aged 15-24 years - 113.3 percent

Although drug overdose deaths are historically associated with urban areas, the latest figures from the CDC show the greatest increases in rural areas between 2004 and 2009. This finding coincides with other research that shows prescription drug abuse, especially of painkillers, is increasing more rapidly in rural areas. In other words, the dramatic increase in drug overdose deaths is not driven by illegal drug use in the inner cities; it is being fueled by prescription drug abuse in white, middle-class, rural America.

To combat the rising hike in accidental prescription drug overdoses, the CDC recommends tightening regulatory measures, improving physician awareness, supporting treatment for drug dependence and possibly modifying the drugs themselves to reduce their potential for abuse. The CDC also recommends that state agencies that manage prescription-monitoring programs try to identify patients who are getting multiple prescriptions from different doctors and identify physicians who write prescriptions beyond what is appropriate, to help to reduce the amount of prescription drug overdoses, by putting these monitoring programs in place.