Trends in Prescription Medication Abuse
Prescription Drugs and Pain Medications: Part 3 of 3
2003 Monitoring the Future Survey (MTF)*
MTF assesses the extent and perceptions of drug use among 8th, 10th, and 12th grade students nationwide. The 2003 survey showed that the lifetime, annual, and 30-day** use of tranquilizers declined significantly from 2002 to 2003 for 10th- and 12th-graders. This is the first year of decline for 12th-graders after a decade of gradual increase; past year use went from 7.7 percent in 2002 to 6.7 percent in 2003. For 10th-graders, it is the second year of decline for annual use, down from 7.3 percent in 2001 to 5.3 percent in 2003. In general, 8th-gradersâ rates of reported tranquilizer use have been considerably lower (about 2.7 percent for annual use) than those observed in the upper grades.
Like tranquilizers, sedative use had shown a decade-long rise among high school seniors before leveling at 9.5 percent in 2002 and 8.8 percent in 2003.
Only 12th grade data are reported for abuse of narcotics other than heroin in the MTF. The annual prevalence of this class of drugs had risen considerably from 3.3 percent in 1992 to 7 percent in 2000 and 6.7 percent in 2001. In 2002, the survey item was changed to incorporate two new specific pain relievers, OxyContin (a controlled-release form of oxycodone that can cause severe health consequences if crushed and ingested) and Vicodin (hydrocodone), and separate items asking about use of these drugs also were introduced. Following the change in the other narcotics item, past year use was reported by 9.4 percent of seniors in 2002 and 9.3 percent in 2003.
Although not significantly higher than in 2002, annual OxyContin use was reported in 2003 by 4.5 percent of 12th-graders, 3.6 percent of 10th-graders, and 1.7 percent of 8th-graders. The annual prevalence rate for Vicodin was considerably higher than for OxyContin, at 10.5 percent in 12th-graders, 7.2 percent in 10th-graders, and 2.8 percent in 8th-graders in 2003. Considering the addictive potential of oxycodone and hydrocodone, these are disturbingly high rates of useâcontrasting with an annual prevalence of less than 1 percent in all three grades for heroin, for instance.
2002 National Survey on Drug Use and Health (NSDUH)***
According to the 2002 NSDUH, an estimated 6.2 million persons, or 2.6 percent of the population, age 12 and older had used prescription medications nonmedically in the month prior to being surveyed. This includes 4.4 million using pain relievers, 1.8 million using tranquilizers, 1.2 million using stimulants, and 0.4 million using sedatives. While prescription drug abuse affects many Americans, some trends of particular concern can be seen among older adults, adolescents, and women.
Lifetime prevalence of pain reliever abuse among youth aged 12 to 17 increased from 9.6 percent in 2001 to 11.2 percent in 2002, continuing an increasing trend from 1989 (1.2 percent). Among young adults aged 18 to 25, the rate increased from 19.4 percent in 2001 to 22.1 percent in 2002; the young adult rate was 6.8 percent in 1992.
In 2002, approximately 1.9 million people aged 12 and older had used OxyContin nonmedically at least once in their lifetimes. An estimated 360,000 Americans received treatment for pain reliever abuse in the past year. The number of new pain reliever users increased from 628,000 in 1990 to 2.4 million in 2001; over half (52 percent) of the new users in 2001 were female.
Lifetime nonmedical use of stimulants increased steadily from 1990 to 2002 for youth aged 12 to 17 (0.7 percent to 4.3 percent). Rates increased between 2001 and 2002 for both youth (3.8 percent to 4.3 percent) and young adults (10.2 percent to 10.8 percent).
2002 Drug Abuse Warning Network (DAWN)****
DAWN collects data on drug-related hospital emergency department (ED) episodes. The latest DAWN findings indicate that drug abuse-related ED episodes involving certain prescription drugs, particularly the benzodiazepines and narcotic analgesics (pain relievers), continued to rise between 1995 and 2002. ED mentions of benzodiazepines increased 38 percent, and mentions of narcotic analgesics/combinations increased from 45,000 to nearly 120,000. By the end of 2002, ED mentions of benzodiazepines and narcotic analgesics/combinations were about as frequent as mentions of heroin or marijuana but ranked below cocaine and alcohol.
Long-term findings indicate that ED mentions of unspecified narcotics, as well as those containing hydrocodone, oxycodone, and methadone rose substantially from 1995 to 2002, increasing 160 percent for hydrocodone combinations, 176 percent for methadone, 341 percent for unspecified narcotic analgesics, and 560 percent for oxycodone/combinations. ED mentions of oxycodone/combinations doubled from 2000 to 2002.
From 2001 to 2002, ED mentions of narcotic analgesics/combinations rose 20 percent. From 2000 to 2002, the increase was 45 percent, and over the 8-year period from 1995 to 2002, ED mentions rose 163 percent. Overall, narcotic analgesics/combinations comprised 10 percent of total ED mentions in the United States in 2002.
In 2002, there were 105,752 mentions of benzodiazepines in hospital EDs, an increase of 16 percent from 2000. Mentions of alprazolam (Xanax) rose 25 percent during that period.
* These data are from the 2003 Monitoring the Future Survey, funded by the National Institute on Drug Abuse, National Institutes of Health, DHHS, and conducted by the University of Michiganâs Institute for Social Research. The survey has tracked 12th-gradersâ illicit drug use and related attitudes since 1975; in 1991, 8th- and 10th-graders were added to the study. The latest data are online at www.drugabuse.gov.
** âLifetimeâ refers to use at least once during a respondentâs lifetime. âAnnualâ refers to use at least once during the year preceding an individualâs response to the survey. â30-dayâ refers to use at least once during the 30 days preceding an individualâs response to the survey.
*** NSDUH (formerly known as the National Household Survey on Drug Abuse) is an annual survey conducted by the Substance Abuse and Mental Health Services Administration. Copies of the latest survey are available at www.samhsa.gov.
**** These data are from the annual Drug Abuse Warning Network, funded by the Substance Abuse and Mental Health Services Administration, DHHS. The survey provides information about emergency department visits that are induced by or related to the use of an illicit drug or the nonmedical use of a legal drug. The latest data (2002) are at www.samhsa.gov.
National Institute on Drug Abuse (NIDA)
National Institutes of Health (NIH)
U.S. Department of Health & Human Services
For more information on addiction to prescription medications, visit http://www.drugabuse.gov/drugpages/prescription.html.