Since I write about the opioid epidemic — what many are calling the worst drug epidemic in United States history — I’ve taken note of recent disturbing stories in the media about increasing numbers of addicts switching from prescription opioids to heroin and other synthetic opioids like fentanyl.
So I wasn’t completely surprised when I read about Stanford research that provides statistical evidence indicating that this trend is real and increasing. As I wrote in a press release on the study, which was published online yesterday in Health Affairs, researchers found that hospital discharges related to prescription opioids declined slightly in recent years, but heroin-related discharges surged.
To reach their findings, the researchers analyzed national trends in hospital inpatient and emergency department discharges for opioid abuse, dependence and poisoning from 1997 to 2014, using data from the Healthcare Cost and Utilization Project, a hospital care database.
The results could be an indication that public health efforts to curtail the rampant over-prescription of opioids, which initially led to the epidemic, are beginning to work. That's according to Tina Hernandez-Boussard, PhD, senior author of the study and an associate professor of biomedical data sciences and surgery, who told me:
I’m cautiously optimistic that prescribing clinicians are positively reacting to the opioid crisis and therefore prescription opioids are contributing less to the overall drug epidemic.
That's the good news. The bad news is that figures remain frighteningly high for all types of opioid use, Hernandez-Boussard said. Opioid deaths in the United States now surpass those due to automobile accidents.
I interviewed another Stanford researcher Anna Lembke, MD, an addiction psychiatrist and author of Drug Dealer, MD: How Doctors Were Duped, Patients Got Hooked, and Why It’s So Hard to Stop, about the findings. Lembke, who didn’t work on this study, said she wasn’t at all surprised by the results and has no doubt many of those addicted to prescription opioids have switched to using heroin or synthetic opioids like fentanyl.
"My patients have told me that's exactly what they did," Lembke said. "Heroin was cheaper and easier to get."
Previously: Overprescribing of opioids is not just limited to a few bad apples, Unmet expectations: Testifying before Congress on the opioid abuse epidemic, The problem of prescription opioids: “An extraordinarily timely topic”, Why doctors prescribe opioids to patients they know are abusing them and Assessing the opioid overdose epidemic
Photo by Michael Coghlan