SOURCES: Beth Han, M.D., Ph.D., M.P.H., statistician, Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Rockville, Md.; Lewis S. Nelson, M.D., professor, department of emergency medicine, NYU School of Medicine, NYU Langone Medical Center, New York City; Oct. 13, 2015, Journal of the American Medical Association
TUESDAY, Oct. 13, 2015 (HealthDay News) -- The percentage of American adults who are abusing prescription narcotic painkillers has dipped slightly in the last decade, a new survey reveals.
That's the good news. The bad news: Those who do abuse these powerful drugs are doing so more frequently and they are more likely to become addicted.
"It is encouraging that the percentage of nonmedical use of opioids [narcotics] decreased," said study author Dr. Beth Han, a statistician with the Center for Behavioral Health Statistics and Quality at the U.S. Substance Abuse and Mental Health Services Administration.
But at the same time, the mixed results "underscore the importance of treatment for substance use disorders," Han added.
"Most adults with prescription opioid [narcotic] use disorders or other substance use disorders neither receive treatment nor perceive a need for treatment," said Han. Her team's report is published in the Oct. 13 issue of the Journal of the American Medical Association.
A second report published in the same journal backs that up: Eighty percent of narcotics abusers fail to get any treatment for their addiction. In fact, treatment rates have remained essentially static since 2004, said the researchers from Johns Hopkins School of Public Health in Baltimore.
The Han analysis included responses provided between 2003 and 2013 by more than 472,000 adults who participated in the annual surveys on drug use.
Respondents indicated whether or not they had ever used prescription narcotics for a non-prescribed purpose during the prior year.
People who said they had were then asked to indicate how often they had done so, how they had obtained the drugs, and at what age they had first abused prescription narcotics.
The same group was also asked to discuss any history of depression and/or substance abuse or dependence. Those substances included alcohol, pot, cocaine and heroin, as well as a wide range of stimulant and/or sedative types of prescription meds.
In addition to a small drop in overall prescription narcotic painkiller abuse between the first survey and the last, investigators also observed a small drop in the percentage of people who said they had abused prescription narcotics for the first time in the prior year (from 1 percent in 2003 to 0.6 percent by 2013).
However, in the same timeframe, more of those who said they abused prescription narcotics abused them more frequently (0.6 percent in 2003 and 0.9 percent by 2013).
Such dependence typically manifests as an uncontrollable desire to keep taking drugs, even in the face of harmful consequences and even when drug use begins to take over a person's life. Increased tolerance (requiring more drugs to achieve the same high) is another sign of dependence, as is difficulty stopping.
A decade of data obtained from the U.S. National Vital Statistics System further revealed that more American adults are now dying from prescription narcotics abuse than before.
Specifically, the analysis found that while 4.5 out of every 100,000 Americans died from a related overdose in 2003, that figure had risen to 7.8 by 2013.
Dr. Lewis Nelson, author of an accompanying editorial, suggested that the findings demonstrate that "the problems associated with opioid [narcotic] misuse are still massive."
According to Nelson, "We have a generation of patients addicted to and overdosing on medications that are unlikely to have been beneficial in the first place." Nelson is a professor in the department of emergency medicine at the NYU School of Medicine at NYU Langone Medical Center in New York City.
"The silver lining may be that fewer patients are using opioids [narcotics] nonmedically, but the dark cloud is that more patients are misusing greater quantities, suffering more [addiction], and are dying," Nelson said.
Reining in the problem will require accepting the fact that "we cannot make [narcotics] safer, and they do not work for most chronic pain," Nelson added.
"We have to reset the expectations for pain relief and function among our prescribers and patients to match this reality," he said. "To this end, raising the bar for the use of opioids for the treatment of either acute or chronic pain will expose fewer patients to their risks."
There's more on painkiller drug abuse at the U.S. National Institute on Drug Abuse.