Rapid increases in the supply of opioid analgesics have largely driven the nearly unremitting increase in overdose deaths in the United States, which have grown by more than 150% over the past decade, from 16 849 in 1999 to 41 502 in 2012.1,2 Since the 1990s, opioid analgesic sales have increased more than 4-fold, with rising and widely variable regional prescribing patterns. Increased market supply makes opioids more available for misuse and diversion to people engaging in recreational use and to people with addiction. In both cases, misuse and diversion increase, elevating population overdose risk. In fact, geographic areas with higher opioid prescribing rates experience higher overdose rates.2 In addition, patient-level data demonstrate that the intensity of opioid exposure, including higher prescribed doses and longer duration of therapy, elevates overdose risk.3,4 Given this opioid-overdose epidemic, the clinical literature is understandably replete with efforts that target individuals most at risk, including strategies such as routine screening for risk of addiction, patient agreements, and urine toxicology monitoring. Unfortunately, these approaches have not yet demonstrated widespread effectiveness in reversing the epidemic.5
Kunins HV. Abuse-Deterrent Opioid Formulations: Part of a Public Health Strategy to Reverse the Opioid Epidemic. JAMA Intern Med. 2015;175(6):987–988. doi:10.1001/jamainternmed.2015.0939
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