Citation

Gross M. Am. J. Public Health 2014; 104(8): 1348.

Affiliation

Former Associate Editor AJPH.

Copyright

(Copyright © 2014, American Public Health Association)

DOI

10.2105/AJPH.2014.302091

PMID

24922146

Abstract

In the late 1990s, new medical practice guidelines intended to address undertreatment of pain coincided with the initiation of Oxycodone marketing, followed by increased use of various opiate products for analgesia. While heroin use remained essentially unchanged during the following decade, prescribed and nonmedical (used without a prescription) opioid consumption increased fourfold. By 2007, enough opiates were in circulation in the United States to dose every citizen with the equivalent of a typical (five mg) dose of Vicodin every four hours for three weeks. In 2009, drug poisoning-accelerated by the rise in prescription painkillers-became the leading cause of death from injury. Strategies introduced to reverse this trend included modification of practice guidelines-notably, in 2006 to address challenges in safe initiation of or switching to methadone from other opiates, and in late 2013 to curb overzealous prescribing of opiate analgesics-and dissemination and optimization of prescription drug monitoring programs to detect "pill mills," curb "doctor shopping" and other forms of drug-seeking behavior, and reinforce the application of effective prescribing practices. (Am J Public Health. Published online ahead of print June 12, 2014: e1. doi:10.2105/AJPH.2014.302091).

Language: en