U.S. government researchers found that nearly one in
three "high use" abusers — people who take opioids between 200 and
365 days a year — obtained a doctor's prescription for the drugs,
compared with about one in five of those who used the drugs less
than 30 days over the course of a year.
High users were also more than three times more likely to buy these
drugs from dealers, researchers wrote in the Journal of the American
Medical Association Internal Medicine.
Less frequent users were more likely to obtain the narcotics at no
charge from people they knew, compared with high use abusers, 62
percent versus 26 percent, according to the review.
Researchers said their analysis shows the need to shift the focus of
prevention to targeting the abuse of prescription narcotics such as
morphine, codeine, oxycodone and hydrocodone.
Prevention programs should concentrate much more on ensuring that
doctors prescribe pain killers judiciously, screen patients carefully and conduct follow-up monitoring of frequent users.
"This is the group where we really need to be targeting our efforts
because they're most at risk for overdose or dependence," lead
author Christopher Jones, former head of the CDC's prescription drug
overdose team, told Reuters.
Jones, now at the Food and Drug Administration's policy office,
added that the results also show the "need to think about what role
do physicians play. How can they be better equipped to identify
patients who are non-medically using and help assist them?"
The findings come as Zohydro, a high-potency prescription opioid
from Zogenix Inc, is set to hit the U.S. market this month, despite
objections from law enforcement officials, addiction experts, drug
treatment providers and physicians.
Jones and his colleagues reviewed data from a government survey on
drug use from 2008 to 2011 and found that, on average,
more than 12 million people age 12 and older were estimated to have
used prescription opioids at least once a year to get high.
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They found several ways people obtain such drugs for non-medical
use: free from friends or family, purchased from someone they know,
purchased from a drug dealer, stolen from a known person, or
obtained through a doctor.
Attention has focused in recent years on the control of
prescription pain killers to help stem abuse, in particular
oxycodone, sold by Purdue Pharma under the Oxycontin brand.
The FDA, which approves medicine for sale in the United States, has
taken measures to curb abuse, such as requiring drug makers to have
risk management plans and to educate doctors.
Zogenix Executive Vice President Bradley Galer said on Monday the
company's risk management program for Zohydro, which includes more
safety information, "will help prescribers understand better what
small subset of patients" are suited for the drug. These are people
who need daily, around-the-clock pain treatment, but have found no
relief with other opioids.
The FDA has recommended tighter restrictions on hydrocodone
products. Last week, the Drug Enforcement Administration said drugs
containing the ingredient should be more tightly restricted along
the lines of morphine and oxycodone. That would make them harder to
obtain, requiring, for example, that doctors write a prescription, not call one in to a pharmacy.
(Reporting by Susan Heavey; editing by
Michele Gershberg and Andre Grenon)
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