The number of prescriptions for opioid medications in the United States decreased for the first time since 1996, according to a New York Times investigation.
Prescriptions for opioid-based painkillers such as OxyContin, Vicodin and Percocet peaked in 2012 and then steadily declined in 2013, 2014 and 2015. An IMS Health report found a 12 percent decrease since 2012, and Symphony Health Solutions reported an 18 percent drop during the same timeframe.
The number of prescriptions has decreased in every state except South Dakota since 2013, according to IMS Health. However, fewer prescriptions has not meant fewer deaths from opioid overdose.
More people died in 2014 from opioid overdoses than ever before, according to the Centers for Disease Control and Prevention. The CDC’s numbers include the illicit drug heroin, which many people began turning to when prescription opioids were no longer available.
According to the New York Times analysis:
Experts, officials and health care workers disagree about the best ways to combat the opioid epidemic, but most agree that reckless prescribing of the highly addictive drugs helped fuel the problem.
“We are seeing an increase in the number of people who are dying from overdoses, predominantly after abuse of prescribed opioid analgesics,” Dr. Nora Volkow, director of the National Institute on Drug Abuse, told Congress in 2014. “This disturbing trend appears to be associated with a growing number of prescriptions in and diversion from the legal market.”
At the start of the new millennium, drug sales multiplied but the number of patients requiring treatment for pain did not grow. By 2012, physicians were prescribing enough opioids for every person in the U.S. to have a bottle, according to the CDC.
But some physicians worry that efforts to end the epidemic are preventing people who need treatment for chronic pain from getting help.
“The climate has definitely shifted,” Dr. Daniel B. Carr, director of Tufts Medical School’s program on pain research education and policy, told the New York Times. “It is now one of reluctance, fear of consequences and encumbrance with administrative hurdles. A lot of patients who are appropriate candidates for opioids have been caught up in that response.”
Overall, Americans are unhappy with efforts to reduce prescription drug abuse, according to an April Kaiser Health poll.
Officials have taken a number of steps to end the problem. The U.S. Food and Drug Administration has added warnings to the labels of opioid medications and pushed the pharmaceutical industry to develop abuse-deterrent pills.
The Centers for Disease Control and Prevention announced guidelines for prescribing opioid medications in March of 2016. The guidelines advise doctors to use the opioid treatment only when no other effective treatment option is available and to prescribe the lowest effective dosage.
Forty-nine states have developed prescription drug monitoring programs to monitor patients’ prescription histories and attempt to prevent overdoses. Getting the doctors to use them is another hurdle.
Tennessee created a database in 2006, but opioid prescriptions increased 12 percent between 2010 and 2012, so the state mandated doctors use the database in 2013. Prescriptions dropped 14 percent between 2012 and 2015, according to the New York Times.
The federal government is also on the verge of enacting expansive legislation to aid in the epidemic. The Senate passed a bill expanding addiction treatment efforts, increasing the availability of naloxone and encouraging appropriate prescribing practices in March. The House passed a series of similar bills in May.