- The Washington Times - Thursday, July 6, 2017

American doctors prescribe four times as many opioids as their European counterparts, government scientists said, drawing the contours of the painkiller epidemic that’s swept the U.S. in recent years.

While the rate of prescriptions peaked in the U.S. in 2010, doctors here are still far more likely than elsewhere to turn to opioids, the Centers for Disease Control and Prevention said. And even with a drop in rates this decade, doctors are still three times as likely as they were in 1999 to order up opioids, the CDC said.

“The bottom line remains we still have too many people receiving opioids prescriptions for too many days at too high a dose,” acting CDC Director Anne Schuchat said.

CDC said prescribing rates increased steadily during the last decade and crested at 81 prescriptions per 100 people in 2010, before sliding down to 70 prescription per 100 by 2015 — the most recent year for which data are available.

The number of opioid-related overdose deaths is rising, however, as powerful synthetics such as fentanyl flood the drug market and claim the lives of people who are already hooked, the report found.

Research shows a significant portion of those who turn to illicit opioids started out on prescription drugs.

“Now that so many people are addicted to opioids, I am afraid that the problem will remain with us for quite some time in the future,” said Richard C. Ausness, a law professor at the University of Kentucky who tracks the issue.

Opioids were linked to roughly 33,000 deaths in 2015, with about half of them from prescription painkillers. The Obama and Trump administrations, working with Congress, have tried in recent years to catch up with the problem, which is affecting every corner of the country.

Endo International, a pharmaceutical company, said Thursday it would voluntarily stop selling Opana after the FDA last month asked it to withdraw the product from the market. The FDA said too many people were abusing the drug by injecting it, leading to the spread of viral injections such as HIV.

In a statement, Endo said their product was safe when used as directed and that it had “taken significant steps over the years to combat misuse and abuse,” though it decided to comply with the FDA’s groundbreaking request.

It was the first time the agency took steps to remove an opioid pain medication from the market due to the health risks tied to abuse.

State attorneys general, meanwhile, are also flexing their muscle, taking opioid manufacturers and companies along the supply chain to court. The prosecutors argue the companies’ marketing and distribution tactics resulted in a glut of pills that fed the opioid epidemic in their towns and cities.

Oklahoma Attorney General Mike Hunter filed one such lawsuit last week, joining Missouri, Ohio and Mississippi as states that are hoping the type of legal strategy that public prosecutors deployed against tobacco companies in the 1990s will help them claim damages from opioid manufacturers.

The Cherokee Nation, largely centered in Oklahoma, has also sued, saying the epidemic has hit Indian country particularly hard.

The CDC said prescribing rates varied widely from county to county, with patients in some areas filling six times the amount of prescriptions as others.

Opioid prescriptions were filled at particularly high rates in large towns and small cities that serve as population centers in rural areas, likely because patients there hadn’t been exposed to other treatment options or clinicians there hadn’t broken the habit of relying on opioids to treat pain.

Areas with high rates of unemployment or people with diabetes and arthritis also prescribed at higher rates since patients might seek out opioids for pain related to those conditions.

The CDC is encouraging doctors to consider nonopioid painkillers or other ways to manage pain, such as physical therapy or exercise.

“We want clinicians to really think twice before they start anyone on an opioid,” Dr. Schuchat said. “That beginning may lead to long-term use and maybe overdose and death.”

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