400% MORE INDIVIDUALS DIED FROM 1999-2008 FROM ILLEGAL USE OF PRESCRIBED NARCOTICS (OXYCODONE, MORPHINE, METHADONE, HYDROCODONE, etc.).
As Physicians attempt to treat Chronic Pain with stronger medications such as Narcotics/Opioids, the numbers of deaths from patients using these medications have risen. The increase in death parallels the increased production of narcotics by drug corporations and increased prescription by physicians of these medications. The overdose death rate in 2008 was nearly four times the rate in 1999. Sales of Opioids in 2010 were four times those in 1999.
The only illicit drug which has never been implicated as a causing death is Marijuana, it is the most widely used substance and researchers have only been able to cause deaths due to Marijuana by using doses which no human could consume at one time.
The number of Deaths from Opioid medications (methadone, oxycodone, or hydrocodone) has continued to rise each year, since 1999. Presently the number of deaths from incorrect or illegal use of Prescription narcotics exceeds the yearly deaths from Heroin and Cocaine combined.
During the same time 1999-2007 deaths from non-opioids, such as, anti-depressants, benzodiazepines (Valium/Xanax, etc.), and anti-Parkinson drugs increased from 9,262 to 12,790.
To put things in perspective, the total number of deaths from
1) Illicit drugs for 2007 was 17,000
2) The misuse and abuse of prescription painkillers was responsible for more than 475,000 emergency department visits in 2009, a number that nearly doubled in just five years.
3) More than 12 million people reported using prescription painkillers nonmedically in 2010, that is, using them without a prescription or for the feeling they cause.
4) Motor Vehicle accidents accounted for 35,000 deaths (The latest statistics hint that death from medications might overtake deaths from MVA in the next few years).
5) 15,000 individuals died in 2008 from illegal opioid usage compared to 2,000 individuals in 1999.
The 400% increase in death from legal prescriptions has placed Physicians and Patients in a difficult situation. Physicians are leery to prescribe narcotics as they do not wish to be responsible for patient deaths, while attempting to treat the patient’s pain. Also Chronic pain patients commit suicide (some studies state that up to 25% of Chronic Pain patients might commit suicide) at a much higher rate than the general population, perhaps, because of unrelenting pain and inability to obtain pain medications.
To avoid becoming a statistic, patients should only
1) Use the amount of medication prescribed by their physician
2) Should their pain worsen, they should contact their physician and follow his/her advice
3) Keep all medications, prescription, or non-prescription, in a safe location that cannot be accessed by children/young adults
4) Do not share any medication with other people, prescription, nor non-prescription.
5) Do not sell prescription medications, not only is this illegal, it might result in the death of a person who has not used Opioid medications previously.
6) Using medications not prescribed for yourself might show up on a urine drug screen, potentially resulting in loss of employment or denial of workers compensation benefits.
As a Patient with Chronic Pain it is important that you work with a physician who is familiar with treating painful conditions and familiar with the various medications available for pain relief. Your doctor will probably require a written contract which states where and how often you can receive pain medications. You might also be required to submit to random urine drug screenings and might have to complete a pain inventory and depression inventory to help the physician assist you in becoming more pain free and help you to perform your activities of daily living more comfortably.

Should you find that your medications are not helping you as much as they did initially, you might require a change in the type of pain medication or addition of other medications which might assist in pain relief. Please consult your Physician prior to making any changes in your therapy.
Psychotherapy, including CBT (Cognitive Behavior Therapy), might also be necessary for you to function optimally.
While these rules are onerous, require hours to complete and might make the patient feel as if she/he is under a microscope, these rules help the patient and the physician to follow the best recommendations for pain management with opioids and help in decreasing the chances that the DEA will come knocking at your or your doctor’s door.
Should you have any other questions please use our ASK DR. JOSHI question form.
http://www.cdc.gov/nchs/data/nvsr/nvsr61/nvsr61_04.pdf
http://jama.jamanetwork.com/article.aspx?articleid=1653518
http://www.cdc.gov/mmwr/pdf/wk/mm5932.pdf
http://www.cdc.gov/mmwr/pdf/wk/mm6043.pdf
http://www.nap.edu/openbook.php?isbn=0309071550&page=109
http://www.cdc.gov/nchs/data/nvsr/nvsr61/nvsr61_04.pdf