Opioid Prescriptions Decline Steadily, But a New Drug Appears

Opioid Prescriptions Decline Steadily, But a New Drug Appears

Created on: Thursday, May 26, 2016
Author: Peter MIchaud

The New York Times reports that opioid prescriptions in the United States have shown a sustained decline for the first time in twenty years—since the advent of oxycodone (Oxycontin®) in 1996. After a peak in 2012, the decline has been evident in 2013, 2014 and 2015. In those years, only South Dakota showed an increase. With the new political awareness of and emphasis on opioid addiction issues, it is expected that this decrease will accelerate in 2016. The largest decrease nationally has been in the prescription of hydrocodone, marketed under the brands Vicodin® and Lortab®.

Unfortunately, the decrease in prescriptions has not affected the increase in fatal opioid overdoses, with Maine seeing 272 such deaths in 2015. In addition, some physicians wonder whether efforts to reduce prescribing are penalizing patients who need such medicines for pain relief and take them responsibly, without diversion or abuse.

Medical schools have made significant efforts during this time to teach students not only about the pain relieving properties of these medicines but also the risks involved. One might wonder whether we will see a pendulum effect, with a large decrease in opioid prescription even for appropriate situations, followed by a damping of the swing while physicians and other health care providers focus on the variety of causative factors leading to substance use disorders and overdose deaths.

Meanwhile, the Bangor Daily News reports a new drug from Canada is raising greater concerns. "W-18”, patented in 1984, has recently been rediscovered by chemists looking for the next cheap and powerful high. While it is being described in the popular press as a synthetic opioid, the drug has not been tested on humans and it is unknown whether naloxone, an opioid antagonist, would work to reverse its effects.

Maine police are warning people about the drug, considered to be many times more powerful than Fentanyl, but it has not yet been seen in this state. If recent history is any indication, we probably don't have long to wait.

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