Those at high overdose risk more likely to use prescribed opioids than borrowed drugs: researchers

Frequent nonmedical uses of opioid painkillers by those at highest risk for overdose are more likely to result from drugs obtained through a doctor's prescription than drugs from a friend or relative, government researchers say.

Frequent users got pain pills with a prescription 27% of the time, compared with getting them from a family member or friend 26% of the time, a research letter published Monday in JAMA Internal Medicine found.

More than half of all users, studied from 2008 to 2011, reported getting their drugs from a friend or relative for free. But those who reported using a prescription painkiller for nonmedical purposes 200 or more days a year were prescribed the medication by their physicians.

Efforts to curb the nonmedical use of prescription painkillers have focused for the most part on infrequent users, those who get the occasional pill for free from a family member or friend. These findings would seem to call that approach into question.

“Many users of opioid pain relievers are going directly to doctors for their drug,” said Centers for Disease Control and Prevention Director Dr. Tom Frieden in a written release. “Healthcare providers need to screen for abuse risk and prescribe judiciously by checking past records in state prescription-drug-monitoring programs. It's time we stop the source and treat the troubled.”

The findings come at a time when anti-substance abuse advocates and health professionals are lobbying federal regulators over the approval of Zohydro ER, which will be the first pure hydrocodone pain reliever sold with a strength experts say that is more than 10 times that of Vicodin.

According to the CDC, overdose deaths have been on the rise during the past decade, reaching more than 38,000 in 2010, more than double the number of drug overdose deaths recorded in 1999. Overdoses from opioid drugs during that time more than tripled, from 4,030 in 1999 to 16,651 in 2010. The steady increase in overdose deaths has been attributed to a large boom in opioid drug sales, which include oxycodone, hydrocodone and methadone. In 2010, the amount of pain relievers sold in the U.S. could have medicated every adult with a 5 mg dose of hydrocodone every four hours for a month, according to the CDC.

Follow Steven Ross Johnson on Twitter: @MHSjohnson