Prescriptions For Painkiller Hydrocodone Dropped Significantly In Five Years
QuintilesIMS Institute, an organization that measures prescription drug use and spending recently published a new report that reveals significantly fewer hydrocodone prescriptions were dispensed in 2016. This is now the fifth year in a row for this trend in the United States.
Hydrocodone is an insanely popular opioid painkiller, indicated for the treatment of moderate to severe pain. It is often combined with acetaminophen in formulations such as Norco and Vicodin. It can also be found in extended-released versions such as Zohydro ER and Hysingla for around-the-clock pain treatment.
This finding offers some evidence that the country’s drug overdose epidemic is now being driven by the use of illicit drugs such as heroin and fentanyl, rather than prescription painkillers.
Hydrocodone prescriptions fell last year by 7 million, and have fallen by more than a third since 2012, a decrease from 136 million prescriptions to 90 million.
In 2012, hydrocodone was #1 in the country for dispensation but now ranks at #4, behind the drugs Zestril, Synthroid, and Lipitor.
In 2014, hydrocodone was placed as a Schedule II controlled substance by the Drug Enforcement Administration, a move that made harder to obtain. Also, last year the Centers for Disease Control and Prevention released new guidelines for opioid prescribing, which discouraged doctors from dispensing them for chronic pain. Still, prescriptions were falling even before the CDC and DEA intervened.
And the DEA has announced plans to reduce the amount most Schedule II opioids manufactured by 25% this year as a means to prevent drug diversion. Hydrocodone’s presence itself is being reduced by one-third to about 58 million prescriptions.
In general, QuintilesIMS reported 13 million fewer prescriptions in 2016 for painkillers, including both narcotics and non-narcotics.
However, prescriptions for gabapentin (Neurontin) increased by 7 million to 64 million last year, a drug that is indicated to treat nerve pain. That number reflects a nearly a 50% increase since 2011.
Also, ibuprofen experienced an uptick in the number prescriptions, increasing by 16% to 44 million since 2012. Pain sufferers are not unaware of this trend – since the CDC’s guidelines have been released, many patients reported receiving fewer opioids, or having their prescriptions cut off altogether. Both doctors and pharmacists also report writing and filling fewer prescriptions for opioids.
The report also revealed that the largest increase in prescription growth was in the areas of hypertension and mental health, and the greatest decline was in the area of pain management.
Still, treatments for pain were the second largest area for therapy, reflecting 460 million prescriptions.
I agree that fewer prescriptions, lower doses and quantities of painkillers should be obtainable to new patients. They should be used for acute pain, and in the treatment of cancer pain and palliative care, for which they are indicated.
However, it is very dangerous to deny those who have already been receiving opioid therapy by cutting them off abruptly. This is why patients begin turning to street drugs such as heroin.
In fact, according to the CDC, as many as 4 in 5 new heroin users report beginning their habit after first becoming addicted to painkillers. Perhaps more doctors need to consider weaning patient off of opioid medications or be willing to help them find treatment for dependence, including opioid replacement therapy.
~ G. Nathalee Serrels, M.A., Psychology