There's been a "dramatic rise" in the distribution of hydrocodone and oxycodone, the nation's two most popular prescription drugs, from 2000 to 2010, according to Drug Enforcement Agency data. Chris Hawley of Bloomberg Businessweek reports hydrocodone distribution has risen most in Appalachia and the Midwest, and oxycodone distribution rose most on Staten Island and in the West.
Increases parallel a rise in overdose deaths, pharmacy robberies and other drug-related crime across the country. Pharmacies dispensed the equivalent of 69 tons of pure oxycodone in 2010. Opioid painkillers, including hydrocodone and oxycodone, caused more than 14,000 deaths in 2008, and the Centers for Disease Control reports the death toll continues to rise. Prescription-drug overdose deaths now outnumber deaths from car accidents.
The increase is partly due to doctors prescribing more painkillers to aging baby boomers, Hawley reports. It's also driven by addiction and "doctor shopping." Advocates for the Reform of Prescription Opioids President Pete Jackson said the addiction problem has roots in Appalachia and affluent suburbs, and spreads out from those two areas. Some areas with military bases or Veterans Affairs hospitals have seen large increases in painkiller use, Hawley reports. In 2010, per-capita oxycodone sales increased five to six-fold in most of Tennessee. Sales also engulfed much of Kentucky, with high rates of sales stretching north to Columbus, Ohio and south to Macon, Ga.
The Southwest is another "hot spot," Hawley reports. Per capita sales of oxycodone rose 10-fold and hydrocodone sales rose five-fold in New Mexico. The state had the highest rate of opioid overdoses in 2008, at 27 per 100,000 people. Hawley reports areas with large Native American reservations saw increases of painkiller abuse, including South Dakota, northeastern Arizona, northern Minnesota and northern Wisconsin. (Read more)
Purdue Pharma recently announced it is conducting clinical trials on OxyContin in children. Immediately some have criticized, suggesting that the exposure to opioids at an early age will inevitably lead to addiction later in life. The larger issue that was missed is that there are times opioids are necessary for children. Children in intensive care units, emergency rooms, post operatively or in rehab often require strong analgesics. These are children with cancer, with severe burns, with sickle cell anemia or other conditions. It would be cruel and inhumane to leave children untreated who experience extraordinary amounts of pain. Of course opioids should not be the first line of therapy if an alternative is available, but they may be the only way to provide relief. So the question is not whether opioids should be used in children but rather how to use them safely when they are necessary. The only way we can know how to safely use medications in children is if they are studied in children. Science should inform patient safety.
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