1
An epidemic is the occurrence of
more cases of disease than would
normally be expected in a specific
place or group of peo...
3
Rx Drug Abuse includes:
OR
OR
Taking someone else’s
prescription for
self-medication
Taking a Rx medication in
a way other...
5
100 people die from drug
overdoses every day in the
United States.
CDC. Vital Signs: Overdoses of Prescription Opioid Pain...
http://www.cdc.gov/HomeandRecreationalSafety/rxbrief/states.html
Enough prescription
painkillers were
prescribed in 2010 t...
0
1
2
3
4
5
6
7
8
9
10
'70 '72 '74 '76 '78 '80 '82 '84 '86 '88 '90 '92 '94 '96 '98 '00 '02 '04 '06
Deathrateper100,000
Her...
Drug Overdose Death Rates by State, 2007
http://www.cdc.gov/HomeandRecreationalSafety/pdf/poison-issue-
brief.pdf 9
http://www.cdc.gov/nchs/data/databriefs/db81.htm
• During the past three decades, the number of drug poisoning deaths incr...
Emergency Department Visits Involving Illicit
Drugs or Non-Medical Use of Pharmaceuticals,
2004-2009
http://www.oas.samhsa...
Deaths
Treatment Admission
Emergency Room
Abuse/Misuse
Non-medical use
2008 Statistics: Opioid Pain Relievers deaths
and R...
http://www.drugabuse.gov/publications/drugfacts/prescription-over-counter-medications
Deaths from Opioid Pain Relievers
13
14
Opioid refers to Narcotic drugs or pain pills
which are DEA controlled substances.
26.7%
15.4%
7.7%
3.5%
4.0%
4.7%
20.2%
2.7%
3.2%
7.4%
4.5%
0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0%
General Practitioners/Fa...
http://www.drugabuse.gov/sites/default/files/rrprescription.pdf
Source of Rx Narcotics
Among Those Who Used in the
Past-Ye...
http://www.drugabuse.gov/sites/default/files/rrprescription.pdf
Total Number of Opioid Rx Dispensed by U.S.
Retail Pharmac...
18
*Includes pain relievers, tranquilizers, stimulants, and sedatives
Note: The specific drug refers to the drug
that was use...
+ Difference between this estimate and the 2010 estimate is statistically significant at the .05 level.
Past Month Nonmedi...
Sales
Deaths
Treatment
Rates of opioid pain
reliever (OPR)
overdose death, OPR
treatment
admissions, and
kilograms of OPR
...
Death Rate
Opioid Sales
Drug overdose death rate in 2008 and rate of
kilograms (kg) of opioid pain relievers (OPR) sold
in...
From the innocent unborn & infants to the
vulnerable elderly our nation has succumb to
the marketing ploy of drug companie...
Patrick, S. W. et al. JAMA
doi:10.1001/jama.2012.3951
Weighted National Estimates of the
Rates of NAS per 1000 Hospital Bi...
http://usatoday30.usatoday.com/news/h
ealth/story/2012-04-29/durg-addicted-
painkller-babies/54646654/1
Number of painkill...
http://www.usatoday.com/news/health/wellness/babies/story/2011-11-13/Doctors-
see-surge-in-newborns-hooked-on-mothers-pain...
Current Substance Use Among Pregnant Women
Aged 15-44, by Age, 2008-2009 Combined
http://oas.samhsa.gov/2k9/135/PregWoSubU...
In 2010, 2 million people
reported using prescription
painkillers nonmedically for
the first time within the last
year—nea...
29
http://www.drugabuse.gov/publications/drugfacts/prescription-
over-counter-medications
Adolescent
College Campus
College
students are
TWICE as likely
to abuse
Adderall® than
non-college
students
http://www.oas.samhsa.gov...
Full-time college students
who used Adderall®
non-
medically in the past year
were and almost FIVE
times more likely to us...
National Institutes of
Health surveys show that
in 2010, the most current
year available, 2.4
million people ages 50-
59 s...
At least one in four older adults use
psychoactive medications with abuse
potential (Simoni-Wastila, Yang, 2006)
Older Adu...
Older Adult admissions for
substance abuse treatment nearly
triples, increasing from 13.7% in
1992 to 39.7% in 2008. CDC.
...
Drug-Related Emergency Department (ED) Visits
Resulting in Hospitalization among Adults Aged 50
or Older, by Type of Visit...
Unintentional Drug Overdose Deaths
by age group and sex, 2007
http://www.cdc.gov/HomeandRecreationalSafety/pdf/poison-issu...
0%
2%
4%
6%
8%
10%
12%
14%
16%
Asians Native
Hawaiians
American
Indians or
Alaska
Native
Two or
More
Races
Hispanics White...
Past Month Illicit Drugs among Persons Aged
12 or Older, by County Type: 2010
http://www.samhsa.gov/data/NSDUH/2k10NSDUH/2...
http://www.hcup-us.ahrq.gov/reports/factsandfigures/2008/pdfs/FF_report_2008.pdf
Adults 18-64 years
old accounted for a
di...
40
http://www.justice.gov/ndic/pubs44/44731/44731p.pdf
Direct and indirect costs attributable to
illicit drug use are estimated in three
principal areas:
http://www.justice.gov/...
• Labor participation costs
• Specialty treatment costs for services
provided at the state level and the federal
level hos...
Lost productivity due to premature mortality
remains a principal component of all costs that
drug use imposes on American ...
Crime cost includes three
components:
$56,373,254 criminal justice
system
$1,455,555 crime victim
$3,547,885 other crime
T...
Health includes five components:
1. Specialty treatment costs ($3,723,338),
2. Hospital & emergency department costs for n...
Drug courts can save states as much
$12,000 per client compared to other
criminal justice strategies, according to
the org...
Saving Lives through Education &
Prevention
Legal Consequences:
2010 Legal Consequences of Prescription Drug
Misuse
Rx Dru...
48
• The US is the only developed country in the world that
does not control RX drug prices.
• The US and New Zealand are ...
Website Sources
http://www.cdc.gov/excite/classroom/intro_epi.htm
http://www.cdc.gov/mmwr/preview/mmwrhtml/su6004a5.htm?s_...
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2012 How did Rx abuse become a National Epidemic in the US

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Information includes: definition of epidemic, abuse, how Rx abuse became an epidemic, national stats on emergency room visits, overdoses, ... who are the supplies, end users... misusers by population, cost to our society & economy, ....

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  • Overdoses involving prescription painkillers—a class of drugs that includes hydrocodone, methadone, oxycodone, and oxymorphone—are a public health epidemic. These drugs are widely misused and abused. One in 20 people in the United States, ages 12 and older, used prescription painkillers nonmedically (without a prescription or just for the "high" they cause) in 2010.
  • The highest drug overdose death rate was found in West Virginia, which was nearly 7 times that of the state with the lowest drug overdose death rate, South Dakota.
  • Of the 36,500 drug poisoning deaths in 2008, more than 40% (14,800) involved opioid analgesics
  • An 'immediate release' liquid or tablet that you take every 2 to 4 hours
  • * Age-adjusted rates per 100,000 population for OPR deaths, crude rates per 10,000 population for OPR abuse treatment admissions, and crude rates per 10,000 population for kilograms of OPR sold.Alternate Text: The figure above shows rates of opioid pain reliever (OPR) overdose death, OPR treatment admissions, and kilograms of OPR sold in the United States during 1999-2010. During 1999-2008, overdose death rates, sales, and substance abuse treatment admissions related to OPR all increased substantially.
  • The lag in death rate to opioid sales/state may be due to death rate #’s are 2008 and sales are 2010. TM.
  • more than twice as likely to use Marijuana (79.9 vs. 27.2%)
  • Older adults are at particular risk for experiencing adverse reactions to medications. Compared with younger adults, they are more sensitive to medications and more likely to take multiple medications because they have more health problems that require treatment.(*2) Older adults may also experience cognitive issues or memory problems that affect their ability to understand and follow medication instructions.(*3) To learn more about how to prevent adverse reactions to medications, older adults and their families can visit http://www.cdc.gov/MedicationSafety/Adult_AdverseDrugEvents.html.
  • By age, the distribution of MHSA hospitalizations differed substantially from the distribution of hospitalizations for all reasons and from the distribution of the U.S. population in 2008. Adults 18-64 years old accounted for a disproportionate share of all MHSA hospitalizations (83 percent) relative to their share of the total population (63 percent) and all hospitalizations (49 percent). While those 65 years and older were responsible for 35 percent of all stays and 13 percent of the U.S. population, they accounted for only 9 percent of MHSA stays.  Children 1-17 years old accounted for 4 percent of all hospital stays and 7 percent of MHSA stays, compared to their population share of 23 percent. Children under 1 year accounted for 1 percent of the overall population, 12 percent of all hospital stays (mostly as newborns), and less than 0.1 percent of MHSA discharges (mostly for drug-related disorders).
  • 2012 How did Rx abuse become a National Epidemic in the US

    1. 1. 1
    2. 2. An epidemic is the occurrence of more cases of disease than would normally be expected in a specific place or group of people over a given period of time. http://www.cdc.gov/excite/classroom/intro_epi.htm http://www.cdc.gov/mmwr/preview/mmwrhtml/su6004a5.htm?s_cid=su6004a5_w 2
    3. 3. 3
    4. 4. Rx Drug Abuse includes: OR OR Taking someone else’s prescription for self-medication Taking a Rx medication in a way other than intended Taking medication to get high http://www.drugabuse.gov/publications/drugfacts/prescription-over-counter-medications 4
    5. 5. 5
    6. 6. 100 people die from drug overdoses every day in the United States. CDC. Vital Signs: Overdoses of Prescription Opioid Pain Relievers—United States, 1999-2008. MMWR 2011; 60: 1-6 http://www.cdc.gov/HomeandRecreationalSafety/rxbrief/states.html 6
    7. 7. http://www.cdc.gov/HomeandRecreationalSafety/rxbrief/states.html Enough prescription painkillers were prescribed in 2010 to medicate every American adult around-the-clock for one month. 7
    8. 8. 0 1 2 3 4 5 6 7 8 9 10 '70 '72 '74 '76 '78 '80 '82 '84 '86 '88 '90 '92 '94 '96 '98 '00 '02 '04 '06 Deathrateper100,000 Heroin Cocaine Rx Medication History of Drug Overdoses http://www.cdc.gov/HomeandRecreationalSafety/pdf/poison-issue-brief.pdF National Vital Statistics System, http://wonder.cdc.gov Eight-Fold Deaths from Drug Overdoses 1970-2007 8
    9. 9. Drug Overdose Death Rates by State, 2007 http://www.cdc.gov/HomeandRecreationalSafety/pdf/poison-issue- brief.pdf 9
    10. 10. http://www.cdc.gov/nchs/data/databriefs/db81.htm • During the past three decades, the number of drug poisoning deaths increased sixfold from about 6,100 in 1980 to 36,450 in 2008 • In 2008, poisoning became the leading cause of injury death in the United States and nearly 9 out of 10 poisoning deaths are caused by drugs. Poisoning is now the leading cause of death from injuries in the U.S. and nearly 9 out of 10 poisoning deaths are caused by drugs. 10
    11. 11. Emergency Department Visits Involving Illicit Drugs or Non-Medical Use of Pharmaceuticals, 2004-2009 http://www.oas.samhsa.gov/2k10/DAWN034/EDHighlights.h tm 11
    12. 12. Deaths Treatment Admission Emergency Room Abuse/Misuse Non-medical use 2008 Statistics: Opioid Pain Relievers deaths and Related Consequences of Misuse 12 (14,800 people) (148,000 people) (473,600 people) (1,924,000 people) (12,210,000 people) 2008, Total number of Drug Overdoses was 36,450 of this number 20,444 were due to Rx abuse and 73% of Rx Deaths or 14,800 were due to opioid pain relievers (OPR). http://www.cdc.gov/injury/about/focus-rx.html http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6043a4.htm#tab1 http://www.cdc.gov/nchs/data/databriefs/db81.htm
    13. 13. http://www.drugabuse.gov/publications/drugfacts/prescription-over-counter-medications Deaths from Opioid Pain Relievers 13
    14. 14. 14 Opioid refers to Narcotic drugs or pain pills which are DEA controlled substances.
    15. 15. 26.7% 15.4% 7.7% 3.5% 4.0% 4.7% 20.2% 2.7% 3.2% 7.4% 4.5% 0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0% General Practitioners/Family Medicine Internal Medicine Dentists Nurse Practitioners Physicians Assistants Emergency Medicine Other Physical Med & Rehab Anesthesiologists Orthopedist Unspec. 15SDI, Vector One: National, 2009. Extracted June 2010. http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/Drugs/AnestheticAndLifeSupportDrugsAdvisoryCommittee/UCM217510.pdf Top 10 Prescribing Specialties immediate-release opioids, 2009
    16. 16. http://www.drugabuse.gov/sites/default/files/rrprescription.pdf Source of Rx Narcotics Among Those Who Used in the Past-Year, 12th Grade 1.10% 11.00% 18.80% 19.50% 32.50% 37.80% 59.10% Internet Other Took from friend/relative Brough from dealer/stranger Presription Bought from friend/relative Given by friend/relative Categories are not mutually exclusive 16
    17. 17. http://www.drugabuse.gov/sites/default/files/rrprescription.pdf Total Number of Opioid Rx Dispensed by U.S. Retail Pharmacies, 1991-2010 17
    18. 18. 18
    19. 19. *Includes pain relievers, tranquilizers, stimulants, and sedatives Note: The specific drug refers to the drug that was used for the first time in the past year, regardless of whether it was the first drug ever used or not. New Users in the Past Year of Specific Illicit Drugs among Persons Aged 12 or Older, 2010 http://www.samhsa.gov/data/NSDUH/2k10NSDUH/2k10Results.htm 19
    20. 20. + Difference between this estimate and the 2010 estimate is statistically significant at the .05 level. Past Month Nonmedical Use of Types of Psychotherapeutic Drugs among Persons Aged 12 or Older: 2002-2010 http://oas.samhsa.gov/NSDUH/2k10NSDUH/2k10Results.htm#2.16 Past Month Nonmedical Use of Types of Psychotherapeutic Drugs among Persons Aged 12 or Older, 2002- 2010 20
    21. 21. Sales Deaths Treatment Rates of opioid pain reliever (OPR) overdose death, OPR treatment admissions, and kilograms of OPR sold --- United States, 1999--2010 21http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6043a4.htm
    22. 22. Death Rate Opioid Sales Drug overdose death rate in 2008 and rate of kilograms (kg) of opioid pain relievers (OPR) sold in 2010 — United States 22http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6043a4.htm
    23. 23. From the innocent unborn & infants to the vulnerable elderly our nation has succumb to the marketing ploy of drug companies encouraging the public to utilize Rx drugs for every minor pain and/or slight feeling of anxiety. Sadly, this ploy is working all too well…. 23 Nonmedical use of Rx Drugs are Destroying Families in the United States
    24. 24. Patrick, S. W. et al. JAMA doi:10.1001/jama.2012.3951 Weighted National Estimates of the Rates of NAS per 1000 Hospital Births per Year NAS indicates neonatal abstinence syndrome. 24
    25. 25. http://usatoday30.usatoday.com/news/h ealth/story/2012-04-29/durg-addicted- painkller-babies/54646654/1 Number of painkiller-addicted newborns Triples in 10 years 25 The Journal of American Medical Association published about 3.4 of every 1,000 infants born in a hospital in 2009 suffered from a type of drug withdrawal commonly seen in the babies of pregnant women who abuse narcotic pain medications. Stephen Patrick of the University of Michigan, neonatal- perinatal medicine stated, “That’s about 13,539 infants a year or one drug-addicted baby born every hour.”
    26. 26. http://www.usatoday.com/news/health/wellness/babies/story/2011-11-13/Doctors- see-surge-in-newborns-hooked-on-mothers-pain-pills/51186076/1 Newborns in Florida 354 481 659 968 1374 0 200 400 600 800 1000 1200 1400 1600 2006 2007 2008 2009 2010 Number of Newborns Treated for Withdrawal Symptom for the State of Florida http://databases.sun- sentinel.com/Orlando/health/orlandoBabies/ftlaudDrugBabies_list.php 26 Opiate Use During Pregnancy: The Short and Long-Term Effects on Women, Babies, and Children
    27. 27. Current Substance Use Among Pregnant Women Aged 15-44, by Age, 2008-2009 Combined http://oas.samhsa.gov/2k9/135/PregWoSubUse.cfm http://oas.samhsa.gov/2k9/135/PregWoSubUse.htm 27
    28. 28. In 2010, 2 million people reported using prescription painkillers nonmedically for the first time within the last year—nearly 5,500 a day. First time Users http://oas.samhsa.gov/NSDUH/2k10NSDUH/2k10Results.htm#2.16 28
    29. 29. 29 http://www.drugabuse.gov/publications/drugfacts/prescription- over-counter-medications Adolescent
    30. 30. College Campus College students are TWICE as likely to abuse Adderall® than non-college students http://www.oas.samhsa.gov/2k9/adderall/adderall.htm 30
    31. 31. Full-time college students who used Adderall® non- medically in the past year were and almost FIVE times more likely to use OxyContin® non-medically (44.9 vs. 8.6 %). 31http://www.oas.samhsa.gov/2k9/adderall/adderall.htm College Campus
    32. 32. National Institutes of Health surveys show that in 2010, the most current year available, 2.4 million people ages 50- 59 said they had abused prescription or illegal drugs within the past month — almost three times as many people as reported that behavior in 2002. Baby Boomers http://www.drugabuse.gov/news-events/nida-notes/2010/12/drug-abuse-highest-level- in-nearly-decade 32
    33. 33. At least one in four older adults use psychoactive medications with abuse potential (Simoni-Wastila, Yang, 2006) Older Adults 33http://www.ncoa.org/improve-health/center-for-healthy-aging/content-library/Prescription- Medication-Misuse-and-Abuse-Webinar-12-12-11.ppt
    34. 34. Older Adult admissions for substance abuse treatment nearly triples, increasing from 13.7% in 1992 to 39.7% in 2008. CDC. Older Adult admissions for substance abuse treatment nearly tripled What happened after ED visit? 52.3% were treated and released 37.5% were admitted to the hospital 34http://www.ncoa.org/improve-health/center-for-healthy-aging/content-library/Prescription- Medication-Misuse-and-Abuse-Webinar-12-12-11.ppt
    35. 35. Drug-Related Emergency Department (ED) Visits Resulting in Hospitalization among Adults Aged 50 or Older, by Type of Visit and Age Group: 2009 http://www.samhsa.gov/data/spotlight/Spot066DrugReaxOlderAdults2012.pdf http://www.cdc.gov/MedicationSafety/Adult_AdverseDrugEvents.html Older adults are at particular risk for experiencing adverse reactions to medications. Compared with younger adults, they are more sensitive to medications and more likely to take multiple medications because they have more health problems that require treatment. 35
    36. 36. Unintentional Drug Overdose Deaths by age group and sex, 2007 http://www.cdc.gov/HomeandRecreationalSafety/pdf/poison-issue-brief.pdf 36
    37. 37. 0% 2% 4% 6% 8% 10% 12% 14% 16% Asians Native Hawaiians American Indians or Alaska Native Two or More Races Hispanics Whites Blacks 4% 6% 16% 10% 10% 9% 8% http://www.samhsa.gov/data/NSDUH/2k10NSDUH/2k10Results.htm 37
    38. 38. Past Month Illicit Drugs among Persons Aged 12 or Older, by County Type: 2010 http://www.samhsa.gov/data/NSDUH/2k10NSDUH/2k10Results.htm 38
    39. 39. http://www.hcup-us.ahrq.gov/reports/factsandfigures/2008/pdfs/FF_report_2008.pdf Adults 18-64 years old accounted for a disproportionate share of all MHSA hospitalizations (83 %) relative to their share of the total population (63 %) and all hospitalizations (49 %). (83 %) 39 (63 %)
    40. 40. 40 http://www.justice.gov/ndic/pubs44/44731/44731p.pdf
    41. 41. Direct and indirect costs attributable to illicit drug use are estimated in three principal areas: http://www.justice.gov/ndic/pubs44/44731/44731p.pdf 32% 6%62% Crime Health Productivity $61,376,694 $11,416,232 $120,303,004 $193 Billion 41
    42. 42. • Labor participation costs • Specialty treatment costs for services provided at the state level and the federal level hospitalization costs • Incarceration costs • Premature mortality costs (nonhomicide & homicide) These subtotal $120,304,004. Dollars in Thousands 42
    43. 43. Lost productivity due to premature mortality remains a principal component of all costs that drug use imposes on American society. Age at Death for Males- Drug Related- 40-45 yrs Age at Death for ALL Males 75-80 yrs 43
    44. 44. Crime cost includes three components: $56,373,254 criminal justice system $1,455,555 crime victim $3,547,885 other crime These subtotal $61,376,694 Dollars in Thousands 44
    45. 45. Health includes five components: 1. Specialty treatment costs ($3,723,338), 2. Hospital & emergency department costs for nonhomicide cases ($5,684,248) 3. Hospital & emergency department costs for homicide cases ($12,938) 4. Insurance administration costs ($544) 5. Other health costs ($1,995,164). These subtotal $11,416,232. 45 Dollars in Thousands
    46. 46. Drug courts can save states as much $12,000 per client compared to other criminal justice strategies, according to the organization. CDC Accidental Overdoses 46www.cdc.gov/HomeandRecreationalSafety/pubs/RXReport_web-a.pdf
    47. 47. Saving Lives through Education & Prevention Legal Consequences: 2010 Legal Consequences of Prescription Drug Misuse Rx Drug Facts & Health Consequences of Misuse: 2010 Facts and Consequences of Nonmedical Use of Prescription Drugs 47
    48. 48. 48 • The US is the only developed country in the world that does not control RX drug prices. • The US and New Zealand are the only countries that allow drug makers to advertise to consumers. • In medical schools the median # of hours for pain education in the United States is 7 at VETINARIAN schools the median required hours is 75. • The pharmaceutical companies spent more on lobbying between 1998 and 2004 than any other industry... employing a legion of lobbyists.. more than two for each member of Congress.
    49. 49. Website Sources http://www.cdc.gov/excite/classroom/intro_epi.htm http://www.cdc.gov/mmwr/preview/mmwrhtml/su6004a5.htm?s_cid=su6004a5_w http://www.drugabuse.gov/publications/drugfacts/prescription-over-counter-medications http://www.ncoa.org/improve-health/center-for-healthy-aging/content-library/Prescription-Medication-Misuse-and- Abuse-Webinar-12-12-11.ppt http://www.drugabuse.gov/sites/default/files/rrprescription.pdf http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/Drugs/AnestheticAndLifeSupportDrugsAdvis oryCommittee/UCM217510.pdf http://www.justice.gov/ndic/pubs44/44731/44731p.pdf http://www.isp.idaho.gov/pgr/Research/documents/drugsandcrime.pdf National Vital Statistics System, http://wonder.cdc.gov http://www.ahrq.gov/news/press/pr2010/hospmedpr.htm Healthcare Cost and Utilization Project (HCUP) http://www.hcup- us.ahrq.gov/reports/factsandfigures/2008/TOC_2008.jsp http://www.hcup-us.ahrq.gov/reports/factsandfigures/2008/pdfs/FF_report_2008.pdf http://www.samhsa.gov/data/NSDUH/2k10NSDUH/2k10Results.htm http://www.drugabuse.gov/news-events/nida-notes/2010/12/drug-abuse-highest-level-in-nearly-decade http://oas.samhsa.gov/2k9/135/PregWoSubUse.htm http://oas.samhsa.gov/2k9/135/PregWoSubUse.cfm 49

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