Friday, June 24, 2016 New Reports Underscore the Severity of the Opioid Epidemic In what's becoming a grim and all-too-familiar pattern, new reports and studies continue to point to alarming trends in the use and abuse of opioids across the US. Combined, they create a picture of a country in the throes of an epidemic that reaches all societal levels, with laws that do little to curb the rise in abuse, and a federal drug regulatory agency that has "opened the gate wide" for the overproduction of prescription opioids. Here's a rundown of a few of the studies and reports that surfaced recently: Nearly 1 in 3 Medicare beneficiaries received an opioid prescription in 2015. A report from the US Department of Health and Human Services (HHS) estimates that 12 million Medicare beneficiaries—about 30%—received a prescription for a commonly abused opioid in 2015, at a cost of over $4 billion in Medicare part D spending. The 4% increase over 2014 rates represents a very modest slowdown from 2013, but the long-range trend shows a 165% increase from 2006. Each Medicare beneficiary who was prescribed a commonly abused opioid received an average of 5 prescriptions a year. The opioids with the highest part D spending were OxyContin, hydrocodone-acetaminophin, oxycodone-acetaminophin, and fentanyl. Nonmedical use of prescription opioids more than doubled between 2002 and 2013. According to a study in the Journal of Clinical Psychiatry (abstract only available for free), nearly 10 million Americans—about 4.1% of the population—reported using opioids without a prescription or not as prescribed in 2012-2013, a 161% increase from the 2001-2002 study period. Overall, 11% of Americans report nonmedical use of prescription opioids at some point in their lifetime, up from 4.7% in 2001-2002. The estimated number of Americans with prescription opioid use disorder has increased by 125%, with 2.1% of the population (4.8 million) reporting the disorder in their lifetime in the 2012-2013 study. Ten years prior, that rate was 0.9%. Tighter controlled substance laws aren't having an impact on opioid abuse, at least among Medicare beneficiaries with disabilities. A study in the New England Journal of Medicinelooked at opioid abuse and overdose rates among Medicare beneficiaries with disabilities, and compared those rates with various state laws enacted to curb abuse over a 7-year period. The study focused on beneficiaries aged 21-64 with disabilities—a population that accounted for nearly 1 in 4 deaths from opioid overdose in 2008. What they found was that laws that limit the prescribing and dispensing of controlled substances had little effect on outcomes. "Effective and safer alternatives for chronic pain management are needed, as is a comprehensive response to opioid addiction," authors write. The DEA is being questioned about its role in the growth of opioid use and abuse. The Washington Post reports that during a US Senate Judiciary Committee hearing, US Drug Enforcement Administration (DEA) Administrator Chuck Rosenberg received a harsh line of questioning from Sen Dick Durbin (D-IL) over the ways in which the agency may have contributed to the current opioid crisis through a decision to "flood America with opioid pills, far beyond any medical purpose." Durbin reported that DEA's production quotas for opioids increased dramatically from 1993 to 2015, with oxycodone production increasing from 3.5 tons to 150 tons, and the production of hydrocodone, hydromorphone, and fentanyl increasing by 12 times, 23 times, and 25 times, respectively. "I think we're part of the problem," Rosenberg admitted at the hearing. APTA has added its voice to the effort to curb opioid abuse through its national #ChoosePT campaign, an initiative to promote physical therapy as a safe and effective alternative to the use of opioids in the treatment of pain. Housed at MoveForwardPT.com/ChoosePT, the #ChoosePT campaign will unfold throughout 2016 and include national online advertising, TV and radio public service announcements, and other targeted advertising and media outreach. APTA is also a member of the White House’s working group addressing the opioid epidemic.