Opioid Prescriptions Fall, Will it Solve the Opioid Epidemic?

By Zachary Siegel 05/24/16

While opiate prescriptions may be on the decline, fatal overdoses from heroin and overdoses are steadily on the rise.

Opioid Prescriptions Fall, Will it Solve the Opioid Epidemic?

Since 2012, the number of painkillers prescribed in the United States has been declining. However, it has not resulted in a decrease of fatal overdoses. 

In a New York Times report, data tracking trends in opioid prescribing were collected and analyzed from several sources. One company’s data, IMS Health, revealed a 12% drop in opioid prescriptions since 2012. A different company, Symphony Health Solutions, reported an 18% decline during those same years. 

In 49 states, opioid prescriptions have been decreasing since 2013, according to the Times. West Virginia and surrounding Rust-Belt towns saw the sharpest reduction, most likely because this area was at one point a veritable hot zone for pill mills, which led to a spate of opioid and heroin overdoses. This region not only sees the highest overdose rates, but is suffering economically, and experts do not see this as a coincidence. 

One would assume that fewer prescriptions means fewer deaths, but that has yet to be the case. Fatal overdoses from heroin and opioids have continued to climb, hitting an all-time high of more than 28,000 in 2014. 

Last month, The Fix reported that the vast majority of people who are prescribed to opioid pain relievers do not abuse them. Furthermore, we noted that people most likely to overdose on opioids obtain them the old fashioned way—from friends and dealers, not doctors. Both of these facts combined explain why a simple decrease in the number of overall prescriptions would not reduce the staggering mortality statistics. 

Yet, there remain two camps: one argues that reining in opioid prescribing has gone too far and pain patients are now suffering as a result; the other argues that opioid prescriptions must be rolled back, even if that means penalizing some patients who are in legitimate pain. This is the “public policy puzzle” described by the Times’ report. 

There appear to be no easy answers. For one, some argue that cutting off the supply of painkillers pushes users to the street, and onto more dangerous drugs like heroin and fentanyl. This may in part explain why a reduction in painkillers has not led to fewer deaths. Still, must people take home 30 Norco for routine dental surgery?

A happy medium would be to establish a system that limits excessive and unnecessary prescribing, while acknowledging people in legitimate pain may require ongoing treatment with opioids and shouldn’t be faulted for it. But that's easier said than done.

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Zachary Siegel is a freelance journalist specializing in science, health and drug policy. His reporting has also appeared in Slate, The Daily Beast, Salon, Huffington Post, among others. He writes often about addiction, sometimes drawing from his own experience. You can find out more about Zachary on Linkedin or follow him on Twitter.