Economic Burden of Prescription Opioid Misuse and Abuse

Scott A. Strassels, PharmD, PhD, BCPS

Assistant Professor
Department of Pharmacy Practice
The University of Texas at Austin
Austin, Texas

Prescription opioid misuse and abuse are a serious public health problem, resulting in significant morbidity, mortality, and economic burden. Yet no other class of analgesic agents provides such broad spectrum efficacy for pain. Thus clinicians are often faced with a significant challenge: ensuring that opioids are available patients in pain, while concurrently taking steps to reduce misuse, abuse, and diversion of prescription pain medications. Here, Dr. Strassels notes that although opioids have been increasingly prescribed to treat pain during the last decade, increased prescribing has not completely mirrored observed increases in serious adverse outcomes. For example, the most rapidly increasing abuse rates have been observed for oxycodone and fentanyl, whereas the most significant contributors to drug-related mortality are thought to be oxycodone and methadone. Prescribers must taking steps to reduce abuse to protect both their patients and their practice. Best practices now require that patients being considered for long-term opioid therapy are screened for the potential of opioid abuse. Moreover, therapy should be structured to allow the clinician to monitor drug taking by the patient. Current research is focusing on developing tamper-resistant opioid formulations that aim to discourage or impede unsafe use.

References

Strassels SA. Economic burden of prescription opioid misuse and abuse. J Manag Care Pharm. 2009;15(7):556-562.
White AG, Birnbaum HG, Mareva MN, et al. Direct costs of opioid abuse in an insured population in the United States. J Manag Care Pharm. 2005;11(6):469-479.
Cicero TJ, Surratt H, Inciardi JA, Munoz A. Relationship between therapeutic use and abuse of opioid analgesics in rural, suburban, and urban locations in the United States. Pharmacoepidemiol Drug Saf. 2007;16(8):827-840.

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