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Why Rethink Opioids?: The Problem of Prescription Opioid Abuse

Abuse of Prescription Opioids Is a Serious and Growing Problem

We need only read the news to be reminded that prescription opioid abuse is a serious problem across our society. Health care providers who prescribe opioids do so under the specter of misuse, abuse, and diversion (see Glossary).1

The problem of prescription opioid misuse, abuse, and diversion will not be solved by any one group of individuals, but clearly, health care providers can play a leading role in helping to encourage the appropriate use of these potentially beneficial but also potentially harmful medications.

Data from the Centers for Disease Control and Prevention indicate that deaths involving prescription opioid overdose have quadrupled in a decade.1-3 Drug overdose deaths overall increased for the 11th consecutive year in 2010. Pharmaceuticals, and prescription opioids in particular, have driven this increase. Of note, opioid-related overdose deaths in women increased by more than 5-fold between 1999 and 2010.4


  1. Adapted from Centers for Disease Control and Prevention. QuickStats: Number of deaths from poisoning, drug poisoning, and drug poisoning involving opioid analgesics—United States, 1999–2010. MMWR Morb Mortal Wkly Rep. 2013;62(12):234.
  2. Jones CM, Mack KA, Paulozzi LJ. Pharmaceutical overdose deaths, United States, 2010. JAMA. 2013;309(7):657-659. PMID: 23423407
  3. Centers for Disease Control and Prevention. Primary Care and Public Health Initiative. Prescription Drug Abuse and Overdose: Public Health Perspective. October 24, 2012. Accessed May 20, 2014.
  4. Centers for Disease Control and Prevention. Vital signs: overdoses of prescription opioid pain relievers and other drugs among women—United States, 1999-2010. MMWR Morb Mortal Wkly Rep. 2013;62(26):537-542. PMID: 23820967

According to these data from the Drug Abuse Warning Network (DAWN), emergency department (ED) visits for nonmedically used prescription opioid medications increased approximately 183% from 2004 to 2011.1 In 2011, ED visits for the adverse consequences of prescription pharmaceuticals totaled 1,244,872—nearly as many as those for illicit drugs (1,252,500).1 Prescription opioid medications were responsible for 488,004 of these ED visits.1


  1. Adapted from Substance Abuse and Mental Health Services Administration (SAMHSA). Drug Abuse Warning Network, 2011: National Estimates of Drug-Related Emergency Department Visits. Rockville, MD: SAMHSA; 2013. HHS Publication No. (SMA) 13-4760, DAWN Series D-39.

National-level data from the Treatment Episode Data Set (TEDS) for 2011, and trend data for 2001 to 2011, show that admissions for treatment of prescription opioid abuse have increased more than 5-fold over this period.1 There were more than 180,000 opioid-related admissions in 2011 alone. These data include patients 12 years and older. Note that TEDS provides information on the demographic and substance abuse characteristics of admissions for the abuse of alcohol and/or drugs to facilities that report to individual state administrative data systems. TEDS is an admission-based system, and each admission does not necessarily represent a unique patient.1


  1. Adapted from Substance Abuse and Mental Health Services Administration (SAMHSA). Treatment Episode Data Set (TEDS). 2001–2011. National Admissions to Substance Abuse Treatment Services. Rockville, MD: SAMHSA Office of Applied Studies; 2013. BHSIS Series S-65, HHS Publication No. (SMA) 13-4772.


  1. Webster LR, Fine PG. Approaches to improve pain relief while minimizing opioid abuse liability. J Pain. 2010;11(7):602-611. PMID: 20444651