Many use prescription painkillers, most see abuse as major health concern

Roughly seven in 10 Americans have been prescribed the medications in their lifetime and 17 percent say they have taken painkillers prescribed for someone else, the researchers found in what they believe is the first national public opinion study on this topic.

The findings, published online Oct. 7 in the journal Addiction, suggest that the public may be poised to support a number of policy measures designed to control what has become an epidemic of abuse, including instituting better medical training in controlling pain and treating addiction, requiring doctors to ensure patients don't receive multiple painkiller prescriptions from different providers and requiring pharmacists to check identification before distributing pain prescriptions.

Over the past decade, there has been a sharp increase in the rates of prescription painkiller abuse, misuse and overdose. Drug overdose -- the majority of which involve opioid pain relievers -- was the leading cause of injury death in 2012, and among people between the ages of 25 and 64, drug overdose surpassed car crashes as the leading cause of injury death.

"This study shows that many Americans have had direct experience using prescription pain relievers and a sizable share have misused or abused these medications themselves or have close friends or family members who have done so," says study leader Colleen L. Barry, PhD, MPP, an associate professor in the Department of Health Policy and Management at the Bloomberg School. "The seriousness of the issue has become salient with the American public."

Fifty-eight percent of survey respondents ranked prescription pain medication abuse as either a very serious or extremely serious health issue, on par with other public health problems such as gun violence and tobacco use, Barry says.

The study, based on a web-based public opinion survey of 1,111 adults in the United States in February 2014, was designed to understand attitudes about prescription painkiller use and abuse. Among the findings: Most people blame those who abuse painkillers and the doctors who prescribe them for the current public health crisis. A majority of respondents to the survey said doctors keep patients on these medications for too long, that it is too easy for people to get multiple pain medication prescriptions and that there is a lack of understanding among patients about how easily they can become addicted.

Prescription painkillers are involved in roughly 475,000 emergency department visits a year and the economic costs of misusing these medications were estimated in 2006 at $50 billion in lost productivity, crime and medical costs.

The researchers say they found broad support for most policy recommendations put forth by leading groups such as the U.S. Centers for Disease Control and Prevention, the White House Office of National Drug Control Policy, the American Medical Association and the Trust for America's Health. Except for policies to expand distribution of medications such as naloxone that can reverse opioid overdose which was supported by only 47 percent of respondents and to increase government spending on addiction treatment which was supported by only 39 percent of those surveyed, there was majority backing for all policies in the survey.

Policy proposals with the highest levels of public support were requiring pharmacies to verify patient identification before giving out prescription pain medication (84 percent), requiring medical school and physician residency programs to provide training for physicians in how to detect and treat addiction to prescription pain medication (83 percent) and requiring medical school and physician residency programs to train physicians to treat chronic pain (82 percent).

"We think this is the perfect time to work on passing policies that can truly impact the crisis of prescription pain reliever abuse," says study co-author Emma E. "Beth" McGinty, PhD, MS, an assistant professor in the Department of Health Policy and Management at the Bloomberg School. "The issue has not yet been highly politicized like some public health issues such as the Affordable Care Act, gun violence or needle exchanges, so we may have an opportunity to stem this epidemic."

"Understanding Americans' Views on Opioid Pain Reliever Abuse" was written by Colleen L. Barry, Alene Kennedy-Hendricks, Sarah E. Gollust, Jeff Niederdeppe, Marcus A. Bachhuber, Daniel W. Webster and Emma E. McGinty. The collaborating researchers are from the University of Pennsylvania, the University of Minnesota School of Public Health, Cornell University and the Philadelphia Veterans Affairs Medical Center.