SECAUCUS, N.J., Sept. 6, 2018 /PRNewswire/ -- More than half
(52 percent) of Americans tested in 2017 misused their prescription
drugs, the same rate as in 2016, but the epidemic is shifting
beyond prescription opioids to encompass other drugs and dangerous
drug combinations, finds a new Health Trends™ report released today
by Quest Diagnostics (NYSE: DGX): Drug Misuse in America 2018.
Based on 3.9 million de-identified test results performed for
patients by Quest Diagnostics between 2011 and 2017, this report is
believed to be the largest of its kind to provide current insights
into prescription and illicit drug use and misuse in the United States based on laboratory
insights.
To access the full report, go to www.QuestPDMReport.com.
"The majority of patients continue to show evidence of drug
misuse, and this problem affects all age groups and both genders.
When it comes to drug misuse, everyone is at risk," said lead
author F. Leland McClure, PhD, MSci,
F-ABFT, director, medical science liaison, medical affairs, Quest
Diagnostics. "The overall rate of misuse did not change, but our
data found significant shifts in the nature of the epidemic. We're
encouraged by a decline in the use of non-prescribed opioids and
other drugs among general care patients, but alarmed by sharp
increases for certain drugs among patients in treatment for
substance use disorders (SUD)."
Among general care patients, who account for more than nine in
ten of patients tested by Quest Diagnostics, the Health Trends
report shows a decline in the use of non-prescribed opioids and
amphetamines, as well as illicit drugs. Among patients in treatment
for SUD, the data show use of non-prescribed and illicit drugs
surged across almost all drug classes. Additionally, for this group
of patients, misuse of heroin and non-prescribed fentanyl increased
nearly 400 percent.
Report reveals dangerous opioid-related drug combining
The Health Trends report additionally found that drug mixing is the
most common type of misuse. One in five (20 percent) test results
showed potentially dangerous concurrent use of opioids and
benzodiazepines in 2017. In almost two-thirds of these cases (64
percent), at least one of the drugs was not prescribed. Patients
who were older and in Medicare were at heightened risk. These
findings were presented at PAINWeek, a national conference held in
September 2018 in Las Vegas.
In addition, the report found that mixing of heroin and fentanyl
– a synthetic opioid that is 50 to 100 times more potent than
morphine – is on the rise. Heroin and fentanyl belong to the opioid
class of drugs, and combinations of the two can powerfully depress
respiration. Among the patient test results that were positive for
heroin, 83 percent were also positive for non-prescribed fentanyl,
nearly double the rate in 2016 (45 percent).
"Quest's Drug Misuse in America 2018 report provides sobering
data-driven insight into one of the most pressing health issues
facing our country. It highlights the need for a sharper focus on
patients with substance use disorders," commented Charles Neighbors, PhD, director of health
services research for Center on Addiction, a nonprofit organization
focused on improving the understanding, prevention and treatment of
addiction. "The surge in heroin and non-prescribed fentanyl among
this group is especially alarming, given its often deadly effect.
Clearly more must be done to ensure this group of patients receives
effective treatment."
Additional findings in the Health Trends report include:
- Gabapentin misuse is on the rise. While use of
non-prescribed gabapentin increased slightly among general care
patients (up 1.8 percent), it surged by nearly 800 percent among
patients in treatment for SUD, the most dramatic rate of increase
of any of the drug classes tracked by Quest. Eight percent of the
substance use disorder treatment population used non-prescribed
gabapentin, compared to 9.6 percent of the general care population.
While the medication is generally not addictive in itself,
gabapentin can exaggerate the effects of opioids. Research shows
that individuals taking prescription opioids and gabapentin
concomitantly have a 49 percent greater risk for opioid-related
death than those treated with opioids only.1
- Use of medical marijuana surged by nearly 620 percent
overall, with the general care population experiencing the highest
rate of increase. Just over two percent (2.1 percent) of the
general care population used medical marijuana, compared to less
than one-half of one percent (0.4 percent) of the substance use
disorder treatment population. Recreational marijuana use dropped
more than 5 percent across both populations, though its overall
rate of use, at 14.7 percent, was still higher than medical
marijuana. "Medical" and "recreational" use of marijuana was
determined based on information about the medication regimen
provided by the patient's physician.
- Cocaine use declined while use of non-prescribed
amphetamines rose, driven by sharp increases among patients in
substance use disorder treatment. Among stimulants, the use of
cocaine declined by 40 percent among all patients tested, but use
of non-prescribed amphetamines increased, driven by surging rates
of use among patients in treatment for SUD.
"Our data suggests that some physicians and patients may be
turning to alternative sources of pain relief, perhaps in response
to mounting controls on opioid prescribing," said report co-author
Jeffrey Gudin, MD, a medical advisor
to Quest Diagnostics and director of pain and palliative care at
Englewood Hospital and Medical Center, New Jersey. "This is a reminder that sharp
restrictions on opioid prescribing alone will not solve the
prescription drug epidemic. Until improved solutions emerge for
treating chronic pain, better monitoring of patients taking
prescription opioids and other potentially dangerous medications is
essential."
The report's methodology, including the strengths and
limitations of Quest data, is described in detail on page 16 of the
report which is available for download at
www.QuestPDMReport.com.
About Quest Diagnostics Health Trends™
Quest
Diagnostics manages the largest database of de-identified
clinical laboratory data, based on 44 billion laboratory test
results. From this data, the company derives clinically significant
insights that empower patients, healthcare practitioners and
policymakers to improve health. Developed in collaboration with top
researchers and institutions, Quest Diagnostics Health Trends™
studies are published in peer-reviewed medical journals and by the
company as a public service. Quest Diagnostics Health Trends™
reports have yielded novel insights to aid the management of
allergies and asthma, clinical (prescription) drug monitoring,
chronic kidney disease, diabetes, heart disease, influenza and
wellness. The company also produces the Drug Testing Index (DTI)™,
a series of reports on national workplace drug positivity trends.
More information about the Quest Diagnostics Health Trends studies
can be found at QuestDiagnostics.com/HealthTrends.
About Quest Diagnostics
Quest Diagnostics empowers
people to take action to improve health outcomes. Derived from the
world's largest database of clinical lab results, our diagnostic
insights reveal new avenues to identify and treat disease, inspire
healthy behaviors and improve healthcare management. Quest annually
serves one in three adult Americans and half the physicians and
hospitals in the United
States, and our 45,000 employees understand that, in the
right hands and with the right context, our diagnostic insights can
inspire actions that transform
lives. www.QuestDiagnostics.com
1 Gabapentin, opioids, and the risk of opioid-related
death: A population-based nested case–control study. Gomes T et al.
https://doi.org/10.1371/journal.pmed.1002396.
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