Painkillers Can Be Killers

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painkillersIn 2013, more people in the U.S. died from a drug overdose than from any other type of “injury.” The surprising fact is that half of the overdose deaths involved prescription drugs, more than two-thirds of which were opioid painkillers. Continuing abuse and addiction issues are not only fueling overdoses, the painkillers (including ones like Ibuprofen) and sedatives have also been linked to an increased likelihood to commit homicide.

Use of painkillers is running rampant. More than 220 million prescriptions for opioid painkillers alone were reportedly written in 2014, with estimated sales of $8.85 billion.

During 2013, nearly two million in the U.S. were either dependent on or abused opioid painkillers; approximately 16,000 died from overdoses, per data from the U.S. Centers for Disease Control and Prevention (CDC). The number of fatalities related to abuse that year was four times the amount at the turn of the century.

The notable increase in abuse of opioids and other painkillers led to a change in the formulation of several prescription medications to be more “abuse deterrent.” Some were given harder protective coatings to make them difficult to chew or liquefy for injecting. Unfortunately, that effort has had little impact. The country’s largest prescription drug manager, Express Scripts, reports that only 1.4 percent of the opioid prescriptions that were filled last year had the abuse-deterrent formulations.

An additional concern is that, whether coated or featuring some other tamper-proof or abuse-deterrent ingredients, the drugs are still as addictive as in regular formulations. The precautions, on those few prescriptions that use them, just limit the ways they are abused.

Furthermore, even those prescriptions that had the precautions built-in were not effective to stem the drug abuse issue. Like Web sites that offer tips for anorexics, there are sites online that share methods for breaking through the coatings using a microwave or soaking them in cola. The lack of effectiveness of the abuse-deterrent painkillers was illustrated by the situation in southern Indiana, when over 150 people got HIV by sharing needles they used to inject Opana, which is a drug that was supposed to be resistant to being liquefied for injection.

The U.S. Food and Drug Administration approved three new painkillers last year that have abuse-deterrent properties. Purdue’s Hysingla was designed to be difficult to liquefy or chew. An unusual tactic is employed by Purdue’s Targiniq and Pfizer’s Embeda’ they reportedly release naloxone when they are crushed to counteract the effect users experience from injecting or snorting the drug. Supposedly, 30 other painkillers are in development, which illustrates the crux of the issue – all these killers of pain can be extremely lucrative for the drug companies and, as America ages, are extremely lucrative.

Besides concerns about the number of people addicted to painkillers, a study in Finland correlates their use with homicides. They analyzed medical records on almost 1,000 people who were convicted of killing someone. The records on the convicts in the country’s drug registry showed use benzodiazepines (sedatives like Xanax and Valium), antidepressants, anti-inflammatory painkillers and opiate-based painkillers.

They found small correlations between sedatives and antidepressants and murder. The big surprise, however, was the connection between painkillers and homicide. Use of opiate painkillers correlated with an 92 percent increased risk of conducting homicides; common painkillers like ibuprofen correlated with a 206 percent increased risk of committing a murder. The stats were higher for those under age 26.

With the prevalence of painkiller prescribing and abuse growing, there needs to be a focus on developing means of dealing with pain other than coming up with new drugs to be overprescribed. Continuing to promote dependence on painkillers, old ones or new ones, does not make sense and, according to the study from Finland, can be creating more killers.

By Dyanne Weiss

New York Times: Painkillers Resist Abuse, but Experts Still Worry
USA Today: When painkillers kill: Column
FORBES: Common Painkillers And Sedatives Linked To Increased Risk Of Homicide, According To Study
Journal of World Psychiatry, June 2015

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