Prescription drug misuse continues to be a serious problem in the United States, according to a new report by Quest Diagnostics. The report, “Drug Misuse in America 2019: Physician Perspectives and Diagnostic Insights on the Evolving Drug Crisis,” finds 51% of drug test results of patients prescribed an opioid or other controlled medication show signs of misuse. One in four (24%) show signs of potentially dangerous drug mixing.
The report also suggests physicians may be overconfident in their ability to recognize prescription drug misuse: 72% of primary care physicians surveyed say they trust their patients to take their controlled medications as prescribed. But they want more education for themselves on spotting and treating addiction. Three-quarters of doctors surveyed would like more information about how to monitor for substance use disorders, and 75% said they wish they had more training on what to do if a patient shows signs of addiction.
The first-of-its kind report includes findings from a new online survey of 500 U.S. primary care physicians, conducted by The Harris Poll, and commissioned by Quest Diagnostics in consultation with Center on Addiction, about prescribing controlled medications, such as opioids, amphetamines, and benzodiazepines, and illicit drugs. It also includes an analysis of more than 4.4 million drug laboratory tests performed by Quest ordered by physicians for patients prescribed controlled medications between 2011 and 2018.
The report finds that drug mixing, the most prevalent form of drug misuse, is underestimated by physicians. While one-fourth of patient test results show signs of potentially dangerous drug mixing, more than half of physicians believe fewer than 20% of patients misuse controlled medications in this way. Quest found that 17% of test results show a combination of opioids and benzodiazepines—potentially a very dangerous mix that can result in overdose.
As access to some pain medications becomes more limited, people begin to misuse others, the report suggests. Gabapentin is emerging as an alternative pain therapy to opioids, and lab tests show misuse of non-prescribed gabapentin has jumped 40% in just the past year. Gabapentin, an anticonvulsant that can be used to relieve neuropathic pain, has recently been classified as a controlled substance in some states.
The report findings underscore the need for patients to ask questions whenever they or a loved one is prescribed a new medication, particularly an opioid or other controlled medication, according to Emily Feinstein, Executive Vice President & Chief Operating Officer at Center on Addiction. “Ask whether you really need it. Is there a non-opioid alternative? If your doctor feels opioids are the best treatment for you, ask for the minimum number of pills, and dispose of the drugs safely,” she advised.
Feinstein recommends that you talk to your pharmacist whenever you or a loved one are prescribed a new drug, to see if it might interact with other drugs you or your family member is already taking. If your teen is prescribed an opioid, talk to them about how to use it safely. Tell them to use it as directed—and check to make sure they are. Emphasize the importance of not mixing opioids with other drugs, or sharing them with anyone.
“For physicians, the report highlights the need for more training,” Feinstein said. One resource is Search and Rescue, a prescriber education campaign developed by the Partnership for Drug-Free Kids that operates on a grant from the U.S. Food and Drug Administration to provide healthcare professionals with the tools and resources they need to help patients with prescription drug misuse, abuse, and addiction.
“It is clear from this report that prescription drug misuse is prevalent and may be missed by doctors. Anyone can be at risk,” Feinstein said. “If you are prescribed a controlled substance, it is important to speak with your doctor about the risk for misuse, dependence and addiction.”