Majority of Americans Are Misusing Prescription Drugs

By Dorri Olds 08/08/16

A new report found that a lot of American adults are still mixing or overusing their prescription drugs while misuse among children has majorly improved. 

Majority of Americans Are Misusing Prescription Drugs

According to the 2016 Prescription Drug Monitoring Report by Quest Diagnostics, the majority of U.S. patients are misusing their prescription drugs. Scientific and medical experts analyzed a national sample of 3,143,739 patients based on five years of lab tests (2011 to 2015). In addition to prescribed opioids, the study tested for heroin, and heroin mixed with benzodiazepine. Hepatitis C virus (HCV) patients—39,231 of them—were also tested. The patients covered both genders and a wide spectrum of ages.

The findings demonstrate that prescription drug misuse is pervasive, but we knew that—America’s drug crisis is a daily trending topic. However, drug misuse among adolescents showed a significant improvement (70% in 2011 to only 44% in 2015). If accurate, that is very encouraging, but it’s always vital to carefully look at studies before accepting conclusions as fact. The Fix reached out to Harvard-trained Dr. Peter Grinspoon, a former opioid addict and author of Free Refills: A Doctor Confronts His Addiction.

The Quest report listed this CDC report as its first resource and referred to this figure:

Rates of opioid pain reliever (OPR) overdose death, OPR treatment admissions, and kilograms of OPR sold (United States, 1999-2010)

“My first thought,” said Dr. Grinspoon, “is that the study is commissioned by Quest, who makes a bundle on drug testing, so of course they’re interested in promoting and highlighting the drug-testing component of the CDC recommendations.”

He added, “Drug tests simply aren’t that accurate. They’re subject to human and lab error, and are rife with both false positives and false negatives. Savvy drug users can outsmart these tests. Any drug testing needs to be interpreted in the context of who is using the drug and why they are using it.”

Stat News quoted Quest’s medical affairs director F. Leland McClure III, who said in a press release, “The discovery that a growing percentage of people are combining drugs without their physician’s knowledge is deeply troubling, given the dangers.”

Grinspoon agreed. “It is critical that a great deal of thought and concern go into the decision of whether or not to prescribe opiates for a particular patient. We doctors are increasingly using a variety of tools to assist us in this, including drug testing, medication contracts, frequent patient visits, pill counts, and prescription monitoring programs. How big a role drug testing does or doesn’t play in this system should depend on the clinical context. There’s no effective ‘one size fits all’ policy. Drug testing should be considered by doctors as one of many tools available, but not mandated, before prescribing opiates.”

He said drug testing would sometimes seem absurd: “To drug test an elderly patient that you know well, hasn’t been on opiates nor abused drugs, and who has come down with an acute, time-limited case of shingles, obviously needs acute pain control with opiates, and it doesn’t add any value to drug test him before prescribing opiates.”

The doc did point out that it does make sense to drug test a new patient who has had issues with drug or alcohol abuse in the past, “or a young person with vague, recurrent symptoms that don’t have a clear anatomical cause,” as these are risk factors for potential opiate abuse. He felt that no patient should be prescribed opiates whenever it can be avoided.

One big problem remains for physicians: addicts aren’t always easily spotted. They're not wearing a big “A” and they’re known to lie on intake forms. Clinicians can easily be fooled.

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Dorri Olds is an award-winning writer whose work has appeared in many publications including The New York Times, Marie Claire, Woman’s Day and several book anthologies. Find Dorri on Twitter, Facebook, and LinkedIn.