Study: OTC drugs, prescriptions send more to ER than cocaine

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Posted 5/10/2006 12:18 AM ET




Misuse of drugs, such as painkiller OxyContin, is a growing problem.
By Donna Leinwand, USA TODAY
Abuse of prescription and over-the-counter drugs is sending more people to emergency rooms than cocaine, according to new federal data that reflect the growing popularity of powerful painkillers such as OxyContin, Vicodin and hydrocodone.

The data, to be released today by the Substance Abuse and Mental Health Services Administration (SAMHSA), show that 1.3 million people visited a hospital emergency room in 2004 for illnesses involving drug abuse. The administration collects data from 417 hospitals and 106 million total emergency room visits.

One in four — or 495,732 — drug-related emergency room visits involved pharmaceuticals: over-the-counter or prescription drugs. One in five — 383,350 — visits involved cocaine. Marijuana was involved in 215,665 emergency room visits.

"We need to see a real focus getting the message out that just because something is prescribed or over-the counter doesn't mean it's not harmful," says SAMHSA administrator Charles Curie. "We want to recognize that medications prescribed by a doctor and taken exactly how the doctor prescribes can work wonders. But if it's not prescribed for you, if it's not taken the way it's intended, it's a recipe for disaster."

Surveys nationwide have shown a surge in prescription-drug abuse. The number of addicts seeking treatment for abusing prescription opiates, while relatively small at 63,243 in 2004, was up 62% from three years earlier, according to data released last month by SAMHSA. About 2.4 million people abused painkillers for the first time in 2004, making it the drug category with the highest number of new users, according to the National Survey of Drug Use and Health.

"These drugs have become very, very popular with people who abuse substances," says Joseph Troncale, medical director for Caron Treatment Centers based in Wernersville, Pa. He says up to 30% of the patients at Caron's drug-rehabilitation centers are being treated for prescription-drug abuse.

The drugs are cheap and readily available on the street, Troncale says.

"OxyContin, Percocet — all these medicines are just being handed out like candy. I think there's too much availability," Troncale says.

Most prescription drugs abused or sold on the street come from pharmacy robberies, pharmacist dealers or doctor dealers, says Mark Caverly, an investigator for the Drug Enforcement Administration.

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Wednesday May 10, 10:00 am ET

WASHINGTON, May 10 /PRNewswire/ -- The Substance Abuse and Mental Health Services Administration today unveiled findings from its new Drug Abuse Warning Network showing almost 2 million drug-related emergency department visits in 2004. Of these, nearly 1.3 million emergency department visits were associated with drug misuse or abuse.


The data show that 30 percent of the 1.3 million drug-related emergency room visits involved only illicit drugs; 25 percent involved only prescription or over the counter medications; 8 percent involved alcohol only in patients underage 21; 15 percent involved illicit drugs and alcohol; 8 percent involved both illicit drugs and pharmaceuticals; and 14 percent involved illicit drugs, pharmaceuticals and alcohol, all in the same individual.

The survey is considered a new baseline for future years, and therefore these estimates cannot not be compared to those from prior years. Changes from the old DAWN survey include an expanded definition of emergency department visits related to recent drug use and a new sample of hospitals that covers the entire United States. The findings are contained in a new report, Drug Abuse Warning Network, 2004: National Estimates of Drug-Related Emergency Department Visits.

"Most of the 1.3 million visits to emergency rooms involving drug or alcohol misuse or abuse are an opportunity for the health care system to intervene and direct patients to appropriate follow-up care," SAMHSA Administrator Charles Curie pointed out. "President Bush is proposing an expanded Access to Recovery program so that people who seek treatment will have more choices and be able to obtain treatment that works for them."

Access to Recovery provides vouchers that let patients choose treatment they believe will work for them.

The 2004 DAWN estimates that cocaine was involved in 383,350 visits to emergency rooms; marijuana was involved in 215,665 visits; heroin was involved in 162,137 visits; stimulants, including amphetamines and methamphetamine, were involved in 102,843; and other illicit drugs such as PCP, Ecstasy, and GHB were involved with much less frequency.

DAWN estimates 495,732 visits to emergency rooms in 2004 related to nonmedical use of prescription and over-the-counter pharmaceuticals. Over half of these visits involved more than one drug (57 percent). Opiates and Opioid analgesics (prescription pain relievers) were the most frequent pharmaceuticals, involved in nearly a third (32 percent) of nonmedical use visits.

Hydrocodone products, involved in 42,491 emergency room visits, oxycodone products, in 36,559 emergency department visits, and methadone in 31,874 visits, were the most frequently used of the prescription pain relievers. DAWN cannot distinguish between methadone in pill form that is prescribed for pain, and methadone in liquid form used for treatment of opiate addiction. Benzodiazepines (anti-anxiety drugs) were involved in numbers of visits (144,385) similar to opiates and opioids.

DAWN measures alcohol in combination with illicit drugs for all ages, and alcohol alone in a patient under the age of 21, but not alcohol alone for those of legal drinking age. DAWN estimates 96,809 emergency room visits involving alcohol for patients under age 21. There were 363,641 emergency department visits by persons of all ages involving the use of alcohol in combination with another substance.

DAWN relies on a national sample of acute-care, general, non-federal hospitals operating 24 hour emergency departments. Estimates for 2004 are based on data submitted by 417 hospitals. Medical records were reviewed retrospectively to find the emergency department visits that were related to recent drug use. Across the 417 hospitals, more than 12 million charts were reviewed, which led to the identification of 279,564 drug-related visits. The data from the 417 hospitals were weighted to represent an estimated 1,997,993 DAWN visits nationwide in 2004 out of an estimated pool of 105,978,433 total emergency room visits across the nation.

The full report is available online at http://dawninfo.samhsa.gov

SAMHSA is a public health agency within the U.S. Department of Health and Human Services. The agency is responsible for improving the accountability, capacity and effectiveness of the nation's substance abuse prevention, addictions treatment and mental health service delivery systems.