Information includes: definition of epidemic, abuse, how Rx abuse became an epidemic, national stats on emergency room visits, overdoses, ... who are the supplies, end users... misusers by population, cost to our society & economy, ....

1. 1

2. An epidemic is the occurrence of
more cases of disease than would
normally be expected in a specific
place or group of people over a
given period of time.
http://www.cdc.gov/excite/classroom/intro_epi.htm
http://www.cdc.gov/mmwr/preview/mmwrhtml/su6004a5.htm?s_cid=su6004a5_w 2

3. 3

4. Rx Drug Abuse includes:
OR
OR
Taking someone else’s
prescription for
self-medication
Taking a Rx medication in
a way other than intended
Taking medication to get high
http://www.drugabuse.gov/publications/drugfacts/prescription-over-counter-medications 4

5. 5

6. 100 people die from drug
overdoses every day in the
United States.
CDC. Vital Signs: Overdoses of Prescription Opioid Pain Relievers—United States, 1999-2008.
MMWR 2011; 60: 1-6
http://www.cdc.gov/HomeandRecreationalSafety/rxbrief/states.html 6

7. http://www.cdc.gov/HomeandRecreationalSafety/rxbrief/states.html
Enough prescription
painkillers were
prescribed in 2010 to
medicate every American
adult around-the-clock for
one month.
7

8. 0
1
2
3
4
5
6
7
8
9
10
'70 '72 '74 '76 '78 '80 '82 '84 '86 '88 '90 '92 '94 '96 '98 '00 '02 '04 '06
Deathrateper100,000
Heroin
Cocaine
Rx Medication
History of Drug Overdoses
http://www.cdc.gov/HomeandRecreationalSafety/pdf/poison-issue-brief.pdF
National Vital Statistics System, http://wonder.cdc.gov
Eight-Fold Deaths from
Drug Overdoses
1970-2007
8

9. Drug Overdose Death Rates by State, 2007
http://www.cdc.gov/HomeandRecreationalSafety/pdf/poison-issue-
brief.pdf 9

10. http://www.cdc.gov/nchs/data/databriefs/db81.htm
• During the past three decades, the number of drug poisoning deaths increased
sixfold from about 6,100 in 1980 to 36,450 in 2008
• In 2008, poisoning became the leading cause of injury death in the United States
and nearly 9 out of 10 poisoning deaths are caused by drugs.
Poisoning is now the leading cause of death
from injuries in the U.S. and nearly 9 out of
10 poisoning deaths are caused by drugs.
10

11. Emergency Department Visits Involving Illicit
Drugs or Non-Medical Use of Pharmaceuticals,
2004-2009
http://www.oas.samhsa.gov/2k10/DAWN034/EDHighlights.h
tm
11

12. Deaths
Treatment Admission
Emergency Room
Abuse/Misuse
Non-medical use
2008 Statistics: Opioid Pain Relievers deaths
and Related Consequences of Misuse
12
(14,800 people)
(148,000 people)
(473,600 people)
(1,924,000 people)
(12,210,000 people)
2008, Total number of Drug Overdoses was 36,450 of this
number 20,444 were due to Rx abuse and 73% of Rx Deaths
or 14,800 were due to opioid pain relievers (OPR).
http://www.cdc.gov/injury/about/focus-rx.html
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6043a4.htm#tab1
http://www.cdc.gov/nchs/data/databriefs/db81.htm

13. http://www.drugabuse.gov/publications/drugfacts/prescription-over-counter-medications
Deaths from Opioid Pain Relievers
13

14. 14
Opioid refers to Narcotic drugs or pain pills
which are DEA controlled substances.

15. 26.7%
15.4%
7.7%
3.5%
4.0%
4.7%
20.2%
2.7%
3.2%
7.4%
4.5%
0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0%
General Practitioners/Family Medicine
Internal Medicine
Dentists
Nurse Practitioners
Physicians Assistants
Emergency Medicine
Other
Physical Med & Rehab
Anesthesiologists
Orthopedist
Unspec.
15SDI, Vector One: National, 2009. Extracted June 2010.
http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/Drugs/AnestheticAndLifeSupportDrugsAdvisoryCommittee/UCM217510.pdf
Top 10 Prescribing Specialties
immediate-release opioids, 2009

16. http://www.drugabuse.gov/sites/default/files/rrprescription.pdf
Source of Rx Narcotics
Among Those Who Used in the
Past-Year, 12th Grade
1.10%
11.00%
18.80%
19.50%
32.50%
37.80%
59.10%
Internet
Other
Took from friend/relative
Brough from dealer/stranger
Presription
Bought from friend/relative
Given by friend/relative
Categories are not mutually exclusive
16

17. http://www.drugabuse.gov/sites/default/files/rrprescription.pdf
Total Number of Opioid Rx Dispensed by U.S.
Retail Pharmacies, 1991-2010
17

18. 18

19. *Includes pain relievers, tranquilizers, stimulants, and sedatives
Note: The specific drug refers to the drug
that was used for the first time in the past
year, regardless of whether it was the first
drug ever used or not.
New Users in the Past Year of Specific Illicit
Drugs among Persons Aged 12 or Older, 2010
http://www.samhsa.gov/data/NSDUH/2k10NSDUH/2k10Results.htm 19

20. + Difference between this estimate and the 2010 estimate is statistically significant at the .05 level.
Past Month Nonmedical Use of Types of Psychotherapeutic Drugs
among Persons Aged 12 or Older: 2002-2010
http://oas.samhsa.gov/NSDUH/2k10NSDUH/2k10Results.htm#2.16
Past Month Nonmedical Use of Types of
Psychotherapeutic Drugs among
Persons Aged 12 or Older, 2002- 2010
20

21. Sales
Deaths
Treatment
Rates of opioid pain
reliever (OPR)
overdose death, OPR
treatment
admissions, and
kilograms of OPR
sold --- United
States, 1999--2010
21http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6043a4.htm

22. Death Rate
Opioid Sales
Drug overdose death rate in 2008 and rate of
kilograms (kg) of opioid pain relievers (OPR) sold
in 2010 — United States
22http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6043a4.htm

23. From the innocent unborn & infants to the
vulnerable elderly our nation has succumb to
the marketing ploy of drug companies
encouraging the public to utilize Rx drugs for
every minor pain and/or slight feeling of
anxiety.
Sadly, this ploy is working all too well….
23
Nonmedical use of Rx Drugs are Destroying
Families in the United States

24. Patrick, S. W. et al. JAMA
doi:10.1001/jama.2012.3951
Weighted National Estimates of the
Rates of NAS per 1000 Hospital Births
per Year
NAS indicates neonatal abstinence syndrome.
24

25. http://usatoday30.usatoday.com/news/h
ealth/story/2012-04-29/durg-addicted-
painkller-babies/54646654/1
Number of painkiller-addicted
newborns
Triples in 10 years
25
The Journal of American Medical
Association published about 3.4
of every 1,000 infants born in a
hospital in 2009 suffered from a
type of drug withdrawal
commonly seen in the babies of
pregnant women who abuse
narcotic pain medications.
Stephen Patrick of the University of Michigan, neonatal-
perinatal medicine stated, “That’s about 13,539 infants
a year or one drug-addicted baby born every hour.”

26. http://www.usatoday.com/news/health/wellness/babies/story/2011-11-13/Doctors-
see-surge-in-newborns-hooked-on-mothers-pain-pills/51186076/1
Newborns in Florida
354
481
659
968
1374
0
200
400
600
800
1000
1200
1400
1600
2006 2007 2008 2009 2010
Number of Newborns Treated for
Withdrawal Symptom
for the State of Florida
http://databases.sun-
sentinel.com/Orlando/health/orlandoBabies/ftlaudDrugBabies_list.php
26
Opiate Use During Pregnancy: The Short and Long-Term Effects on Women, Babies, and
Children

27. Current Substance Use Among Pregnant Women
Aged 15-44, by Age, 2008-2009 Combined
http://oas.samhsa.gov/2k9/135/PregWoSubUse.cfm
http://oas.samhsa.gov/2k9/135/PregWoSubUse.htm
27

28. In 2010, 2 million people
reported using prescription
painkillers nonmedically for
the first time within the last
year—nearly 5,500 a day.
First time Users
http://oas.samhsa.gov/NSDUH/2k10NSDUH/2k10Results.htm#2.16 28

29. 29
http://www.drugabuse.gov/publications/drugfacts/prescription-
over-counter-medications
Adolescent

30. College Campus
College
students are
TWICE as likely
to abuse
Adderall® than
non-college
students
http://www.oas.samhsa.gov/2k9/adderall/adderall.htm 30

31. Full-time college students
who used Adderall®
non-
medically in the past year
were and almost FIVE
times more likely to use
OxyContin®
non-medically
(44.9 vs. 8.6 %).
31http://www.oas.samhsa.gov/2k9/adderall/adderall.htm
College Campus

32. National Institutes of
Health surveys show that
in 2010, the most current
year available, 2.4
million people ages 50-
59 said they had abused
prescription or illegal
drugs within the past
month — almost three
times as many people as
reported that behavior in
2002.
Baby Boomers
http://www.drugabuse.gov/news-events/nida-notes/2010/12/drug-abuse-highest-level-
in-nearly-decade
32

33. At least one in four older adults use
psychoactive medications with abuse
potential (Simoni-Wastila, Yang, 2006)
Older Adults
33http://www.ncoa.org/improve-health/center-for-healthy-aging/content-library/Prescription-
Medication-Misuse-and-Abuse-Webinar-12-12-11.ppt

34. Older Adult admissions for
substance abuse treatment nearly
triples, increasing from 13.7% in
1992 to 39.7% in 2008. CDC.
Older Adult admissions for substance abuse
treatment nearly tripled
What happened after ED visit?
52.3% were treated and released
37.5% were admitted to the hospital
34http://www.ncoa.org/improve-health/center-for-healthy-aging/content-library/Prescription-
Medication-Misuse-and-Abuse-Webinar-12-12-11.ppt

35. Drug-Related Emergency Department (ED) Visits
Resulting in Hospitalization among Adults Aged 50
or Older, by Type of Visit and Age Group: 2009
http://www.samhsa.gov/data/spotlight/Spot066DrugReaxOlderAdults2012.pdf
http://www.cdc.gov/MedicationSafety/Adult_AdverseDrugEvents.html
Older adults are at particular risk for experiencing adverse reactions to
medications. Compared with younger adults, they are more sensitive to
medications and more likely to take multiple medications because they
have more health problems that require treatment.
35

36. Unintentional Drug Overdose Deaths
by age group and sex, 2007
http://www.cdc.gov/HomeandRecreationalSafety/pdf/poison-issue-brief.pdf 36

37. 0%
2%
4%
6%
8%
10%
12%
14%
16%
Asians Native
Hawaiians
American
Indians or
Alaska
Native
Two or
More
Races
Hispanics Whites Blacks
4%
6%
16%
10% 10% 9% 8%
http://www.samhsa.gov/data/NSDUH/2k10NSDUH/2k10Results.htm 37

38. Past Month Illicit Drugs among Persons Aged
12 or Older, by County Type: 2010
http://www.samhsa.gov/data/NSDUH/2k10NSDUH/2k10Results.htm 38

39. http://www.hcup-us.ahrq.gov/reports/factsandfigures/2008/pdfs/FF_report_2008.pdf
Adults 18-64 years
old accounted for a
disproportionate
share of all MHSA
hospitalizations (83
%) relative to their
share of the total
population (63 %) and
all hospitalizations
(49 %).
(83 %)
39
(63 %)

40. 40
http://www.justice.gov/ndic/pubs44/44731/44731p.pdf

41. Direct and indirect costs attributable to
illicit drug use are estimated in three
principal areas:
http://www.justice.gov/ndic/pubs44/44731/44731p.pdf
32%
6%62%
Crime
Health
Productivity
$61,376,694
$11,416,232
$120,303,004
$193 Billion
41

42. • Labor participation costs
• Specialty treatment costs for services
provided at the state level and the federal
level hospitalization costs
• Incarceration costs
• Premature mortality costs (nonhomicide &
homicide)
These subtotal $120,304,004.
Dollars in Thousands
42

43. Lost productivity due to premature mortality
remains a principal component of all costs that
drug use imposes on American society.
Age at Death for Males- Drug Related- 40-45 yrs
Age at Death for ALL Males 75-80 yrs
43

44. Crime cost includes three
components:
$56,373,254 criminal justice
system
$1,455,555 crime victim
$3,547,885 other crime
These subtotal $61,376,694
Dollars in Thousands
44

45. Health includes five components:
1. Specialty treatment costs ($3,723,338),
2. Hospital & emergency department costs for nonhomicide
cases ($5,684,248)
3. Hospital & emergency department costs for homicide cases
($12,938)
4. Insurance administration costs ($544)
5. Other health costs ($1,995,164).
These subtotal $11,416,232.
45
Dollars in Thousands

46. Drug courts can save states as much
$12,000 per client compared to other
criminal justice strategies, according to
the organization. CDC Accidental Overdoses
46www.cdc.gov/HomeandRecreationalSafety/pubs/RXReport_web-a.pdf

47. Saving Lives through Education &
Prevention
Legal Consequences:
2010 Legal Consequences of Prescription Drug
Misuse
Rx Drug Facts & Health Consequences of Misuse:
2010 Facts and Consequences of Nonmedical Use
of Prescription Drugs
47

48. 48
• The US is the only developed country in the world that
does not control RX drug prices.
• The US and New Zealand are the only countries that allow
drug makers to advertise to consumers.
• In medical schools the median # of hours for pain
education in the United States is 7 at VETINARIAN schools
the median required hours is 75.
• The pharmaceutical companies spent more on lobbying
between 1998 and 2004 than any other industry...
employing a legion of lobbyists.. more than two for each
member of Congress.

49. Website Sources
http://www.cdc.gov/excite/classroom/intro_epi.htm
http://www.cdc.gov/mmwr/preview/mmwrhtml/su6004a5.htm?s_cid=su6004a5_w
http://www.drugabuse.gov/publications/drugfacts/prescription-over-counter-medications
http://www.ncoa.org/improve-health/center-for-healthy-aging/content-library/Prescription-Medication-Misuse-and-
Abuse-Webinar-12-12-11.ppt
http://www.drugabuse.gov/sites/default/files/rrprescription.pdf
http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/Drugs/AnestheticAndLifeSupportDrugsAdvis
oryCommittee/UCM217510.pdf
http://www.justice.gov/ndic/pubs44/44731/44731p.pdf
http://www.isp.idaho.gov/pgr/Research/documents/drugsandcrime.pdf
National Vital Statistics System, http://wonder.cdc.gov
http://www.ahrq.gov/news/press/pr2010/hospmedpr.htm
Healthcare Cost and Utilization Project (HCUP) http://www.hcup-
us.ahrq.gov/reports/factsandfigures/2008/TOC_2008.jsp
http://www.hcup-us.ahrq.gov/reports/factsandfigures/2008/pdfs/FF_report_2008.pdf
http://www.samhsa.gov/data/NSDUH/2k10NSDUH/2k10Results.htm
http://www.drugabuse.gov/news-events/nida-notes/2010/12/drug-abuse-highest-level-in-nearly-decade
http://oas.samhsa.gov/2k9/135/PregWoSubUse.htm
http://oas.samhsa.gov/2k9/135/PregWoSubUse.cfm
49