April 6th, 2010
12:01 AM ET

Report: Hospitalizations spike for prescription drug poisonings

By Ann J. Curley
CNN Medical News Assignment Manager

Recent celebrity deaths from prescription drug overdoses – including actors Corey Haim, Brittany Murphy, and Heath Ledger- have created headlines but the problem is widespread, according to a new study out Tuesday. Unintentional poisoning deaths are second only to motor vehicle deaths for unintentional injury in the U.S. and that number has been rising since 1992, according to the Centers for Disease Control and Prevention.

The new study, published in the May edition of the American Journal of Preventive Medicine, finds that U.S. hospitalizations for poisoning by prescription opioids, sedatives and tranquilizers have jumped 65 percent from 1999 to 2006. That number is almost twice the increase in hospitalizations for poisonings by all other drugs and medicinal substances. “People are seeing headlines...and thinking 'it's sad and tragic but maybe it's just Hollywood,’ said lead author Jeffrey H. Coben, M.D., a professor and director of the Injury Control Research Center at the West Virginia University School of Medicine. “It's widespread throughout the U.S. and involves serious hospitalizations and is escalating at a rapid pace."

"The public needs to understand that prescription medications are just as dangerous as street drugs like heroin and cocaine, and they shouldn't have a false sense of security just because they are taking prescription drugs,” Coben said. “It's important to use those drugs exactly as prescribed and not in combination with other drugs."

The authors examined records of hospitalizations for poisonings, using the Nationwide Inpatient Sample, the largest all-payer inpatient care database in the U.S. The NIS contains data on more than 7 million hospital stays from approximately 1,000 hospitals and is often used for developing national and regional estimates for hospitalization trends. Estimated hospitalizations for poisoning by prescription opioids, sedatives, and tranquilizers increased a total of 65 percent from 1999 to 2006. For comparison, hospitalizations for poisonings by other drugs, and substances increased only 33 percent. Intentional poisonings from prescription opioids, sedatives, and tranquilizers rose by 130 percent compared with intentional poisonings from other substances during the same period. And the most dramatic increase in poisoning hospitalizations during the seven-year period was for methadone, which increased 400 percent.

Some of the increase in opioid prescription use can be explained by initiatives introduced in 1997 by medical organizations such as the American Academy of Pain Medicine, the American Pain Association, and the American Society of Anesthesiologists, which promoted better pain management for chronic pain patients, including cancer patients, Coben said. But "the prescriptions for pain medications are often diverted and used for recreational purposes," he said.

Coben says that treating patients for prescription drug poisonings opens a door for caregivers. "One opportunity is to work more directly with people being seen in hospital emergency rooms for prescription drug poisonings. We don't know for sure that they are at increased risk for death, but they should be treated as a high-risk group and we need to learn a lot more about the factors that contributed to the overdoses and engage those patients in substance abuse treatment, if needed, to reduce any-long term risks."

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soundoff (8 Responses)
  1. Dr. Andres Vinuela

    Whatever happened to prescribing one medication at at time?
    Physicians need to review their pharmacology and ask themselves one simple question. Would I be as aloof if it was my grandmother whom I was prescribing these medications. If you never had a grandmother then maybe consider your pet, car or whatever. I am extremely perplexed at the magnitude of this "epidemic" that is costing us our loved ones.

    April 6, 2010 at 13:14 | Report abuse | Reply
  2. dsangal

    RE: Dr. Vinuela, 04-06-2010 13:14 ET
    I'm hoping you're talking about one PAIN medication at a time. Responsible use of multiple medications for other conditions is both common and necessary.
    For example, my bipolar disorder was not controlled until my doctor tried numerous individual and combined drug regimens with me. My bipolar is now successfully stabilized using two medications: one that addresses the depressive part of the cycle, and another for the manic phase.
    At the same time, I'm taking prescription meds for blood pressure, essential tremor, and pain (along with OTC analgesics for augmentation of the prescription pain med). I have been on this regimen for several years, and aside from the 'ramp up' period, it's been very effective and unproblematic.

    April 7, 2010 at 10:05 | Report abuse | Reply
    • Dr. Andres Vinuela

      Yes Sir,
      I am talking mostly about combining pain meds with benzo's and then partying all night drinking booze and then wondering why your best friend will not wake up.

      February 25, 2011 at 21:42 | Report abuse |
  3. Dr. Tanya Claiborne

    As a pharmacist in the emergency department I have seen a consistent tide of patients with intentional and unintentional ingestions. The access to not only prescription drugs but over-the-counter medications that the general public deems as "safe" is alarming. We need more programs that connect pharmacists with physicians to recognize high risk populations for overdose.

    April 7, 2010 at 10:15 | Report abuse | Reply
  4. Ron Iverson, MD, FACEP

    I believe that regulatory agencies (Joint Commission, CMS) are contributing to this problem by forcing physicians to measure pain on a pain scale and control patients pain. Often the only way to control pain is through the use of narcotics.

    Furthermore, patients also know they can "report" us to the Joint Commission if we do not adequately control pain. We have spent many hours and thousands fo dollars responding to complaints from patients for failure to give patients adequate amounts of narcotics. I am convinced this is a factor in the massive addiction problem. It also contributes to the cost of health care.

    April 7, 2010 at 11:43 | Report abuse | Reply
    • Megan Lint

      I would just like to say. A lot of these people that you call "addicts", have severe pain. And it's because doctors accuse ANYONE of trying to get drugs, that people can't get at least temporary relief until they can get the help that they need. Like myself for instance. I have Lumbar Spinal Stenosis, plus scoliosis. I have very severe pain. There's days I miss work because I cannot get out of bed. Doctors are very hesitant to prescribe me any kind of medication that is close to a narcotic.

      Of course there's problems with drug abuse. In every city, of every country, there will always be "addicts". You can make it illegal, you can ban it. People will still get it. The answer lies is WHY they got addicted. WHY did they do it in the first place? Don't punish the rest of us because of other people.

      August 24, 2010 at 13:36 | Report abuse |
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    January 30, 2011 at 22:28 | Report abuse | Reply
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