Hope for Saving Lives While Facing an Overdose Epidemic

Since 1999, over 160,000 Americans, many of them otherwise healthy, have died from a prescription opioid overdose. But we're beginning to see a turn in the tide and evidence that healthcare providers can and will make the difference in this fight.
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As an emergency physician, I've treated many patients with acute and painful injuries after car crashes or falls. Although I've prescribed short doses of opioids for patients with arm fractures or other painful injuries, I have also seen a growing epidemic of patients addicted to these medications. Not a shift goes by without my seeing a patient who is dependent on prescription opioids and needs a referral to substance abuse treatment more than another prescription for an opioid painkiller. Patient safety is my first concern and I've been on the frontlines witnessing this prescription drug overdose epidemic. Since 1999, over 160,000 Americans, many of them otherwise healthy, have died from a prescription opioid overdose. But we're beginning to see a turn in the tide and evidence that healthcare providers can and will make the difference in this fight.

After rising steadily for more than 15 years, we are seeing the first decrease in overdoses and deaths involving a prescription opioid. According to CDC data, prescription opioid deaths in the United States declined slightly by 5 percent in 2012. Moreover, opioid prescribing rates have not increased since 2010. Although too many people are still dying from these drugs --16,000 in 2012 -- our strategies to prevent these tragedies are working, and they are likely to have positive effects on closely related issues, like heroin overdose deaths, over the long term.

Before this most recent downturn, deaths from prescription opioid overdoses quadrupled since 1999. From 1999 to 2010, opioid prescriptions also quadrupled even though Americans report no change in the amount of pain they experience. An opioid, hydrocodone, is the most commonly prescribed drug in America. Over 259 million prescriptions for opioids were dispensed by retail pharmacies in 2012 -- enough prescriptions to give every American adult their own bottle of pills.

Overprescribing opioids leads to more abuse and overdose. Not surprisingly, overdose rates are higher in states where opioids are prescribed more frequently. CDC is working with partners and states to improve prescription drug monitoring systems that collect and analyze prescribing data so that doctors and pharmacists are aware of other medications a patient may be taking before prescribing or dispensing opioids. These systems can help reduce the chance that a patient may receive multiple opioid prescriptions.

CDC and other HHS and federal partners help states expand and improve prevention efforts that work. The Prescription Drug Overdose: Boost for State Prevention program funds five states (KY, OK, TN, UT, WV) to identify and put into practice strategies that help prevent high-risk prescribing. At the same time, CDC is working to help healthcare providers make informed clinical decisions that increase patient safety without compromising care.

The slight decline in prescription opioid-related deaths is encouraging news that shows states and health care providers can reverse this epidemic and improve patient safety. I will do my part as a physician by checking my state's prescription drug monitoring program before prescribing a refill of an opioid and by having difficult conversations with my patients about addiction. And as the new Director of CDC's National Center for Injury Prevention and Control, I will continue to promote those interventions that make an impact to reverse the epidemic. We must continue to use real-world solutions to prevent opioid overdose while ensuring people have access to safe and effective pain treatment in every state.

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