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US Pharm. 2013;38(3):6.
National Center for Health Statistics data revealed that more than
one-quarter of people aged 20 years and older (77 million Americans) had
pain for more than 24 hours. Individuals aged 45 to 64 years (30%) had
pain for more than 24 hours, in contrast to 25% and 21% for those aged
20 to 44 years and 65 years, respectively. On average, workers lost 4.6
hours of productive time per week because of pain. Nearly 77% of lost
productive time was due to reduced work performance, not absenteeism.
Trends in Nonmedical Use: According to a National
Survey on Drug Use and Health report, nonmedical use of prescription
drugs is the nation’s second most prevalent illicit-drug problem (after
marijuana), as well as a public-health concern. The number of emergency
department visits linked to nonmedical use of prescription pain
relievers nearly doubled between 2004 and 2009. In 2007, nearly 28,000
Americans died from unintentional drug poisoning; of these, nearly
12,000 cases involved prescription pain relievers. According to the
Treatment Episode Data Set for 1998 to 2008, the proportion of all
admissions for substance-abuse treatment in individuals aged 12 and
older taking pain relievers for nonmedical use increased fourfold, but
the proportion dropped from 2009–2010 (4.9%) to 2010–2011 (4.6%).
Nonmedical use of pain relievers in persons aged 12 years and older
increased at a mean of 1.65% per year between 2002 and 2011, for an
average of 28.9% of all illicit drug use. Nonmedical use of pain
relievers was most frequent in individuals aged 26 years and older
(42.7%), followed by those aged 12 to 17 years (30.15%) and those aged
19 to 25 years (27.14%). Dependence on pain relievers was most common
among persons aged 26 years and older (56.1%), followed by those aged 18
to 25 years (34.5%); those aged 12 to 17 years were a distant third
(9.5%). Of individuals who initiated use of pain relievers for
nonmedical purposes in 2011, 60.3% were female and 83% were
first-timers. In that year, 35.5% of persons aged 12 to 17 years, 37.1%
of those aged 16 to 25 years, and 27.3% of those aged 26 years and older
initiated use of pain relievers for nonmedical purposes.
Discussion: According to an Institute of Medicine
report, pain is a significant public-health problem that costs society
$560 billion to $635 billion annually ($2,000 per person). Efforts to
reduce the nonmedical use of pain relievers have made some progress, but
health care professionals must increase awareness among their patients
about the implications of such use.
To comment on this article, contact rdavidson@uspharmacist.com.
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