The New York Times recently reported
that opioid prescriptions are declining for the first time since OxyContin
became available in 1996. The decline in
prescriptions is estimated to be between 12% and 18% since 2012. While opioid prescriptions
have declined in almost every state since 2013 (South Dakota being the only
exception), the number of fatal overdoses from opioids has not. Over 28,000 people died of an opioid overdose
in 2014. This figure includes both overdoses of prescribed opioids and heroin.
According
to the article, prior to the 1990s, opioids were typically prescribed only
after surgery or to treat pain from a terminal illness like cancer. Starting in the 1990s, doctors increasingly began
to use opioids to treat chronic conditions like back pain. As a result, opioid
sales rose from $1 billion in 1992 to $10 billion in 2015.
In 2014,
the federal government reclassified several hydrocodone-based drugs (e.g.,
Vicodin), making them harder to prescribe.
Dispensed prescriptions declined by 22% in the year after the change
took effect. State prescription drug monitoring programs have also helped
reduce the number of opioid prescriptions.
While the
decrease in opioid prescriptions is often viewed as a success for public policy,
Dr. Daniel B. Carr, the director of Tufts Medical School’s program on pain
research education and policy, warns that doctors’ reluctance to prescribe
opioids may be harming patients who truly need them. As quoted in the article, Carr says that the
climate “is now one of reluctance, fear of consequences and encumbrance with
administrative hurdles. A lot of
patients who are appropriate candidates for opioids have been caught up in that
response."
