Poisoning is now the second leading
cause of unintentional injury death in the U.S. While several recent
high-profile Hollywood celebrity cases have brought the problem to
public attention, the rates of unintentional poisoning deaths have been
on the rise for more than 15 years, and in fact, unintentional poisoning
has surpassed motor vehicle crashes as the leading cause of
unintentional injury death among people 35-54 years of age. In a study
published in the May issue of the American Journal of Preventive
Medicine, researchers found that hospitalizations for poisoning by
prescription opioids, sedatives and tranquilizers in the U.S. have
increased by 65% from 1999 to 2006.
"Deaths and hospitalizations associated with prescription drug
misuse have reached epidemic proportions," said the study's lead author,
Jeffrey H. Coben, MD, of the West Virginia University School of
Medicine. "It is essential that health care providers, pharmacists,
insurance providers, state and federal agencies, and the general public
all work together to address this crisis. Prescription medications are
just as powerful and dangerous as other notorious street drugs, and we
need to ensure people are aware of these dangers and that treatment
services are available for those with substance abuse problems."
In the first comprehensive examination of nationwide
hospitalizations associated with these prescription medications,
researchers examined data gathered from the Nationwide Inpatient Sample
(NIS), which contains records for approximately 8 million
hospitalizations per year. By using standard diagnosis codes from the
ICD-9-CM, the authors extracted from the NIS all poisonings by drugs,
medicinal, and biological substances reported from 1999-2006, and
further categorized the specific types of drugs in each case. It was
also possible to determine whether the poisoning was diagnosed as
intentional, unintentional or undetermined.
Dr. Coben believes that while the data reveals a fast-growing
problem, there's an urgent need for more in-depth research on this wave
of injuries and deaths. Writing in the article, he said, "Interviews
with survivors could provide important additional details regarding the
pathways to abuse of these drugs, the methods used to obtain the
medications, the sequencing and combination of drugs that result in
overdose, and the immediate precursors to these serious events. The
association between hospitalization for prescription opioids, sedatives,
and tranquilizers and subsequent morbidity and mortality is another
area in need of further research."
While the majority of hospitalized poisonings are classified as
unintentional, substantial increases were also demonstrated for
intentional overdoses associated with these drugs, likely reflecting
their widespread availability in community settings.
From 1999-2006, total estimated hospitalizations in the U.S. for
poisoning by prescription opioids, sedatives, and tranquilizers
increased by 65%; while unintentional poisonings by these drugs
increased by 37%. In comparison, during this same period,
hospitalizations for poisoning by other drugs, medicinal and biological
substances increased by 33%, while all other hospitalizations increased
by just over 11%. Unintentional poisonings by other substances increased
by 21%. Intentional poisonings from prescription opioids, sedatives,
and tranquilizers rose by a total of 130% compared to a 53% increase in
intentional poisonings from other substances.
The largest percentage increase in hospitalizations for poisoning
for a specific drug was observed for methadone (400%). Poisonings by
benzodiazepines increased 39%. Hospitalizations for poisoning by
barbiturates actually decreased 41%, as did hospitalizations for
poisoning by antidepressants (a decrease of 13%).
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