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.

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