Overuse of Prescription Painkillers May Be a Risk Factor for Diverting Medication

Some young adults who receive prescription painkillers for acute pain, such as that from a dental procedure or a broken bone, might have enough medication to both overuse it and divert to others, a new study suggests.

The study of 192 young adults found that 58 percent followed their doctor’s instructions for using their prescription painkiller; 27 percent underused their medication, and 16 percent overused it. The researchers found that 27 percent of all those studied diverted their medication. Of those who overused their medication, 63 percent diverted some—they were almost five times as likely to share, sell or trade their medication as those who used their medication as prescribed. Overusers were eight times as likely as underusers to divert their medication, the researchers report in the journal Pain Medicine.

“We are concerned that these individuals might have had enough medication from the prescription to both overuse it and divert it,” says study lead author Amelia M. Arria, PhD, Director of the Center on Young Adult Health and Development at the University of Maryland School of Public Health in College Park. “The research underscores the importance of ‘judicious dosing’ for managing acute pain conditions similar to what has been advised for chronic pain management.”

While much is already known about people who misuse prescription painkillers, less is known about the characteristics of individuals who divert this type of medication, says Dr. Arria, who is also the Scientific Director of the Parents Translational Research Center at the Treatment Research Institute. “This research shows that non-adherence to a medication regimen for acute pain conditions might be a risk factor.”

Dr. Arria and her colleagues explored the alternative idea that young adults who underused their medication would be more likely to divert it since they had extra unused doses. “We found instead that underusers were the least likely to divert medication, perhaps because they might be more risk averse,” she says.

Because many doctors are not initiating conversations with patients about medication diversion, parents of high school and college-age young adults should consider taking the lead, Dr. Arria advises. “When teens are prescribed an opioid analgesic, parents should initiate a conversation with their teen and/or with the doctor about the dangers of diverting the medication.”

Physicians also need practical ways to accurately assess which patients might be more at risk for diverting medication, she says. “We need an easy tool that doctors can use when they are prescribing opioid analgesics, which includes a few questions and talking points about medication diversion.” She adds that specific prescribing guidelines for dentists, who write opioid analgesic prescriptions for tooth extractions, and for orthopedic surgeons, who write them for sports injuries, might be useful.

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    Steve Billiter

    June 25, 2011 at 5:23 PM

    I agree that prescription painkiller addictions have been problematic from their inception, just like alcohol and opium have been for thousands of years. I had a problem myself for about 11 years with Vicodin; Percocet; etc. Now I see a strong push in governments within America to now tighten prescribing criteria for these drugs, as well as increased coverage by Join Together.

    What could happen is that physicians will become overly wary about prescribing painkillers, especially if laws become really prohibitive, and the pendulum will begin to swing the other way. Certainly, physicians feel more comfortable with observed conditions such as a compound fracture, recent surgery, and similar; but many extremely painful conditions are unobservable to the eye, and may be very painful indeed. Then it may be a matter if the doctor believes the patient nor not. With drug seekers flooding clinics and hospital emergency rooms, there may be no way to accurately ascertain ones “real” pain level without doing extensive, cost- prohibitive tests. However, a simple urinalysis will reveal if the patient has taken any narcotics prior to the visit.

    So what could happen in the future is that needed painkillers will become harder to obtain forcing patients to use illegal drugs; illegally purchased, street- prescription medications, and even alcohol. Heroin, the most powerful pain killer is legal in some European countries, yet illegal in America. How many terminally ill patients with terrible pain have suffered needlessly because morphine or Dilaudid is no longer effective for them? America, and the world has lost the war on drugs and alcohol/tobacco use, and it will certainly get far worse in the future. Pharmaceutical companies have become very rich to be sure.

    While I do not advocate a free-for-all on any dangerous drugs, (alcohol is by far the most problematic) it’s time for America, and drug prevention/treatment professionals to realize that overly stringent laws are counter-productive, and that prevention emphasis should be focused on education and this timeless principle: “Be not deceived; God is not mocked: for whatever a man sows, that shall he also reap.”1 It is everyone’s responsibility to fully understand the consequences of prescription drug abuse and addictions.
    6″Give strong drink [as medicine] to him who is ready to pass away, and wine to him in bitter distress of heart.” 7″Let him drink and forget his poverty and [seriously] remember his want and misery no more”.2


    1. Galatians 6:7 AKJV Bible.
    2. Proverbs 31:6,7. Amplified Bible

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