National Institute on Drug Abuse P rescription D rug A buse: An Escalating Public Health Threat P rescription D rug A buse: An Escalating Public Health

National Institute on Drug AbuseNational Institute on Drug Abuse

Prescription Drug Abuse:An Escalating Public Health Threat

Millions of Americans Abuse Prescription Drugs

Current (Past Month) Use of Prescription Drugs for Non-Medical Purposes

2007 National Survey on Drug Use and Health

Source: SAMHSA, NSDUH 2007

Stimulants Sedatives & Tranquilizers Pain Relievers0

1

2

3

4

5

6

1.1 million

2.1 million

5.2 million

Mil

lion

s of

Am

eric

ans

Annual Numbers of New Nonmedical Usersof Pain Relievers: 1965-2002

Thousands of New Users

0

500

1,000

1,500

2,000

2,500

3,000

1965 1970 1975 1980 1985 1990 1995 2000

All Ages

Aged Under 18

Aged 18 or Older


astaton

if we update I think we have to put a break in after 2002...need to check. Update from http://oas.samhsa.gov/NSDUH/2k7nsduh/tabs/Sect8peTabs29to30.pdfTable 8.29A

1995 1996 1997 1998 1999 2000 2001 20020

20000

40000

60000

80000

100000

120000

42,857 44,02850,584 54,516

64,534

75,837

90,232

108,320

Em

erge

ncy

Dep

t. V

isit

s

Drug Abuse Related ED Visits:Involving Narcotic Analgesics:

1995 - 2002

Source: SAMHSA, The Dawn Report: Narcotic Analgesics, 2002 Update, September 2004

As Prescriptions Increase Emergency Room Visits for Non-Medical Use Also Increase

1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 20060

20,000,000

40,000,000

60,000,000

80,000,000

100,000,000

120,000,000

140,000,000

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

Hydrocodone Prescriptions Oxycodone Prescriptions

Emergency Visits Emergency Visits

Num

ber

of P

resc

ript

ions

(mill

ions

)

ED

Men

tion

s (t

hous

ands

)

Source: SDI Health, VONA and SAMHSA, DAWN 2002, 2008

DAWN Update

Number of Past Year Initiates of Substance Use Among Persons Aged 12 or Older


Pain R

eliev

ers

Mar

ijuan

a

Tranquili

zers

Cocai

ne

Ecsta

sy

Inhal

ants

Stimula

ntsLSD

Sedat

ives

Heroi

nPCP

0

500

1000

1500

2000

2500

2147 2090

1232

906781 775

642

270 198 106 58

Nu

mb

er o

f P

ast

Yea

r In

itia

tes

(t-

hou

san

ds)

Percentage of U.S. 12th Grade Students Reporting Past Month Use of

Cigarettes and Marijuana, 1975 to 2008

CESAR FAX January 19, 2009, Vol. 18, Issue 2.Adapted by CESAR from University of Michigan, “Trends in 30-Day Prevalence of Use of Various Drugs in Grades 8, 10, and 12,”Monitoring the Future study, 2008.

Cigarettes

Marijuana

40%

30%

20%

10% 1978 1982 1986 1990 1994 1998 2002 20061976 1980 1984 1988 1992 1996 2000 2004 2008

Oxycontin Vicodin0

2

4

6

8

10

12

4

9.6

4.5

10.5

5

9.3

5.5

9.5

4.3

9.7

5.2

9.6

4.7

9.7

2002 2003 2004 2005 2006 2007 2008

Per

cen

t of

12t

h G

rad

ers

Issues of ConcernPercent of 12th Graders Reporting Nonmedical Use

of OxyContin and Vicodin in the Past Year Remained High

Source: University of Michigan, 2008 Monitoring the Future Study

*No year-to-year differences are statistically significant.

32.4

9.76.8 5.8 6.2 5.5 5.9 4.4 4.7 4.3 3.4

05

101520253035

Prescription/Over-the-Counter Drugs Account for 7 out of 11 of the Most Frequently Abused Drugs

In 2008, 15.4% of 12th graders reported abusing prescription drugs within the past year.

Source: University of Michigan, 2008 Monitoring the Future Study

Prevalence of Past Year Drug Use Among 12th GradersP

erce

nt

of 1

2th G

rad

ers

Mean Age at First Use Among Past Year Initiates of Substance Use Aged 12 to 49

Age

in Y

ears


Sources of Prescription Drugs among Nonmedical Users


Between 1999 and 2005 there was a near doubling of unintentional poisoning

deaths mainly from opioid analgesic abuse

Between 1994 and 2004 there was a 300% increase in treatment admissions for

opioids other than heroin (as primary abused drug)

Why Has the Abuse of Prescription Drugs Been Increasing?

Reasons Youth Give For Abusing Prescription Medications:

• Safer than illicit drugs

• Inexpensive, easy to get

• Not illegal

• Less social stigma than illicit drugs

• Parents soft attitudes about their use

• Performance enhancement (stimulants)

Increased Media Attention

Find the Balance:• Reduce suffering for

patients with pain• Increase awareness of the

abuse potential of opioid medications

NIDA is working to engage primary care physicians and dentists as our partners in recognizing, preventing & treating drug abuse

Find the Balance:• Reduce suffering for

patients with pain• Increase awareness of the

abuse potential of opioid medications

NIDA is working to engage primary care physicians and dentists as our partners in recognizing, preventing & treating drug abuse

What Do We Do?

SDI Health: Vector One® National and Total Patient Tracker

• SDI Health, LLC– Collects data from a representative sample of pharmacies, payers, and other third

party data providers (over 99% of pharmacies captured)– As of 2006 over 56,100 pharmacies nationwide

• VONA: Vector One National– Each month, nearly 50% of the retail prescriptions dispensed are collected and

projected through methods that stratify by geography, pay type and class of trade– Trend data available for prescription counts from 1991

• TPT: Total Patient Tracker – Projects the unique number of patients taking a therapy or multiple therapies over

time– Patient based data available as of 2002

Opioids Include Codeine & Comb NON-INJ (USC 02232), Morphine & Opium NON-INJ (USC 0222), Morphine & Opium INJ (USC 0221), Codeine & Comb INJ (USC 02231).

Source: SDI Health, TPT 2008 09-29-08 Opiates and US Census

National Estimated Prevalence (Rate per 1,000 Population, aged 0 to 85+)

Of Persons with a Dispensed Opioid Prescription, by Specialty, 2007

0-4 5-9 10-14 15-19 20-24 25-29 30+ 0

10

20

30

40

50

60

70

26

12

53 5458

49

GP/FM/DO Dentists IM EM Ortho Surg Uspec

Age Group

Pre

vale

nce

Rat

e/1,

000

Pop

.




Of Persons with a Dispensed Opioid Prescription, by a Dentist, by Year

0-4 5-9 10-14 15-19 20-24 25-29 30+ 0

10

20

30

40

50

60

70

2002 2003 2004 2005 2006 2007

Age Group

Pre

vale

nce

Rat

e/1,

000

Pop

.




Of Persons with a Dispensed Opioid Prescription, by a GP/FP/DO, by Year

0-4 5-9 10-14 15-19 20-24 25-29 30+ 0

10

20

30

40

50

60

70

2002 2003 2004 2005 2006 2007

Age Group

Pre

vale

nce

Rat

e/1,

000

Pop

.

40% 38% 38% 38% 37% 37%

19% 17% 17% 16% 15% 14%

60% 62% 62% 62% 63% 63%

81% 83% 83% 84% 85% 86%

0%

25%

50%

75%

100%

2002 2003 2004 2005 2006 2007 2002 2003 2004 2005 2006 2007

Per

cent

Pre

scri

ptio

ns

Dentists All Others

New Trxs Refill Txs


Source: SDI Health, VONA 2008 11-12-08 Opiates

Prescriptions Dispensed by US Retail Pharmacies by Type of Prescription, 2002 - 2007

Monitoring the Future

• Annual school survey by the University of Michigan funded by NIDA– 12th graders since 1975– 8th and 10th graders since 1991

• 2008 Sample:– 386 public and private schools– 46,348 students

• Questionnaires are administered to students in their classrooms

NSDUH National Survey on Drug Use & Health

• Annual nationwide survey funded by SAMHSA– Includes civilian, noninstitutionalized population aged 12 years old or older

residing within the United States• 2007 survey

– Respondent sample of 67,870 persons representative of the U.S. general population aged 12 or older (since 1991, the civilian, noninstitutionalized population)

• Data collection– In-person computer assisted interviews with sample persons, incorporating

procedures that would be likely to increase respondents' cooperation and willingness to report honestly about their illicit drug use behavior

Documents

National Institute on Drug Abuse P rescription D rug A buse: An Escalating Public Health Threat P rescription D rug A buse: An Escalating Public Health