Most people who abuse prescription opioid drugs get them for free from a friend or relative – but those at highest risk of overdose are as likely to get them from a doctor’s prescription, CDC researchers reported today in a research letter, “Sources of Prescription Opioid Pain Relievers by Frequency of Past-Year Nonmedical Use: United States, 2008-2011,” in the Journal of the American Medical Association Internal Medicine (JAMA Internal Medicine).
This finding underscores the need for prevention efforts that focus on physicians’ prescribing behaviors and patients at highest risk for overdose.
“Many abusers of opioid pain relievers are going directly to doctors for their drugs,” said CDC Director Tom Frieden, M.D., M.P.H. “Health care providers need to screen for abuse risk and prescribe judiciously by checking past records in state prescription drug monitoring programs. It’s time we stop the source and treat the troubled.”
Data have shown that the majority of all people who use opioids for nonmedical reasons (using drugs without a prescription, or using drugs just for the “high” they cause) get the drugs from friends or family for free. Prevention efforts have focused on this group, emphasizing methods such as collecting unused medications through take-back events that are aimed at providing a safe and convenient way of disposing of prescription drugs responsibly.
But these efforts fail to target those at highest risk of overdose: people who use prescription opioids nonmedically 200 or more days a year. CDC’s new analysis shows that these highest risk users get opioids through their own prescriptions 27 percent of the time, as often as they get the drugs from friends or family for free or buy them from friends. And they are about four times more likely than the average user to buy the drugs from a dealer or other stranger.
Researchers analyzed data for the years 2008 through 2011 from the Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Survey on Drug Use and Health (NSDUH). Other major sources of opioids for frequent nonmedical users include obtaining drugs from friends or relatives for free (26 percent), buying from friends or relatives (23 percent), or buying from a drug dealer (15 percent).