More Than Half of Americans Misuse Prescriptions, Though Rate Drops

There’s good news and bad news in new data from Quest Diagnostics about how Americans are using prescription drugs: while more than half (52%) are misusing prescription drugs, that rate has dropped 11% since the last survey 5 years ago.

The report, “Prescription Drug Misuse in America: Diagnostic Insights in the Growing Drug Epidemic,” was released Wednesday during PAINWeek, being held in Las Vegas, Nevada. It measures drug misuse by tracking inconsistent results, which occur when a test result shows that a person is taking a drug that is illicit or isn’t prescribed, or the test shows the person isn’t taking the drugs that were prescribed.

Rising abuse of prescription opioids, which has led to heroin use, has fueled a record number of drug-related deaths: the CDC reported 33,000 people died in 2015, the most ever recorded. Nearly half of all opioid overdose deaths involve a prescription drug, the report states.

The epidemic forced CDC to issue a new prescribing guideline that calls on physicians to look to other ways to alleviate pain before prescribing opioids and to limit the duration of the first prescription. Several states passed laws limiting the duration of the first opioid prescription to less than 10 days.

But the Quest data reveal some signs of hope: teenagers (10-17 years of age) showed a huge drop in inconsistency rates, from 70% to 29% over the 5-year period.

Those who are misusing drugs are doing so dangerously, however. Testing showed:

• Specimens of drug misuse are seen across age groups, including men and women of child-bearing age.
• Of 33,000 specimens tested for both opioids and benzodiazepines, more than 20% were positive for both.
• More than 10% of the 33,833 specimens were positive for alcohol and opioids.
• More than 3% were positive for alcohol, opioids, and benzodiazepines.
• Among specimens that tested positive for heroin, 19% were also positive for non-prescribed fentanyl, a schedule II drug often added without the user’s knowledge that can depress respiration.

While inconsistency rates were highest among patients enrolled in Medicaid (67%), they were high across all payer types: Medicare (50%), private payers (51%). The report said the higher rates in Medicaid may reflect more frequent testing and patient medical conditions.

Drug misuse rates were nearly the same between men and women: 52.8% vs 51.8%, respectively. But what they misuse differed. Men are more likely to use marijuana, while women are more likely to take non-prescribed benzodiazepines. Younger adults use marijuana, while older adults use benzodiazepines.

The primary problem with benzodiazepines is that users become dependent on the drugs, and then physicians cannot prescribe other pain relievers. It’s a mistake to think that opioids are the only drug being misused, the report said.

“Between 2009 and mid-2015, benzodiazepine prescriptions were steady at more than 80 million prescriptions per year. In the period from August 2014 to July 2015, 19% of the prescriptions were for adults age 20 to 39, 41% for ages 40 to 59, and 38% for age 60 and over. More than two-thirds were for female patients.”