The Nonmedical Use of Pain Relievers Steadily Increasing

Pharmaceutical pain relievers used as prescribed medications for the treatment of severe and chronic pain have high potential for abuse and dependence and have been of significant concern for some time. Research data released this year confirms that the nonmedical use of pain relievers is a substantial public health concern. According to information collected by the Office of Applied Studies at SAMHSA (Substance Abuse and Mental Health Services Administration), the use of pain relievers in the U.S. has steadily increased over recent years causing them to become a significant class of substances among those seeking treatment for substance disorders. SAMSHA’s TEDS system (Treatment Episode Data Set) which tracks substance abuse treatment admissions in the United States, found that the nonmedical use of pain relievers increased significantly in the years between 1998 and 2008 among those seeking substance treatment. This increase indicates a dramatic need for prevention and treatment efforts that target these substances.

More specifically, the Treatment Episode Data Set (TEDS) recorded the first, second and third substance of abuse among those admitted to substance abuse treatment in that ten year period. It found a fourfold increase (from 2.2 to 9.8 percent) in the nonmedical use of prescription pain relievers among those admitted for treatment during that time. This included the use of pain relievers such as hydrocodone, oxycodone, morphine and other morphine-like medications.

TEDS indicates significant availability of pain relievers and pervasive misuse of them across the United States and in all walks of life. The increases in pain reliever use were found to have occurred across all demographic categories including age, gender, race, ethnicity, education, employment and geographic region. How individuals gained access to the pain relievers varied, but the majority of those in this set of data were apt to obtain these substances without prescription and from a friend or relative for free.

The information given in this TEDS study included drug use in individuals over the age of 12 who are admitted to substance abuse treatment facilities. The pain reliever use cited by those in this study included primary, secondary or tertiary use (first, second or third preference among substances used). It is significant, however, that the misuse of pain relievers was second only to the use of cannabis among all who were studied.

While use of pain relievers increased across the board, there were dramatic increases in pain reliever use among certain groups. Specifically, in the age group 18 to 34 there was an increase in those who reported use from 1.5 percent in 1998 to 13.7 percent in 2008. Other notable increases occurred among those identifying themselves as Non-Hispanic White (from 3.2 percent in 1998 to 14.4 percent in 2008) and American Indian. This last group was 6 times more likely to use pain relievers in 2008 than in 1998. Geographically, the percentages of admissions for pain reliever abuse increased almost fourfold in all U.S. areas except the West which showed a slower but significant increase as well (1.9-6.1%).

Among other populations that showed a significant increase in the nonmedical use of pain relievers were individuals with a co-occurring psychiatric disorder. These numbers rose from 3.4 percent reporting pain reliever abuse in 1998 to 14.4 percent in 2008. Also, previous treatment did not seem to have an impact upon the rising numbers of those who report use of pain relievers during later episodes of treatment. The proportion of those who had been in substance disorder treatment previously and returned to a program also showed an increase in pain reliever use over the years. Similarly, the proportion of those who use pain relievers and who are new to substance abuse treatment have steadily increased as well during the 10 year period from 1998-2008.

If you believe someone you care about is using increasingly risky amounts of pain relievers, a drug intervention may be something to consider.