Trends in Medical Use and Abuse of Sustained-Release Opioid Analgesics: A Revisit

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Abstract
Objective. Previous literature suggests that increases in the medical use of opioids over the early 1990s did not contribute to increased morbidity secondary to opioid abuse. Our objective was to evaluate the period 1997–2001 to analyze trends in medical use and medical abuse of three classes of opioid analgesics that are commonly used in sustained-release formulations: fentanyl, morphine, and oxycodone. Design and Setting. A retrospective analysis of the Drug Abuse Warning Network (DAWN) database and the Automation of Reports and Consolidated Orders System (ARCOS) database for the years 1997–2001 was used for this study. Results. The analysis of the DAWN database showed that there was an 83.5% increase in all opioid analgesic mentions from 1997 to 2001. Mentions involving any fentanyl compound increased 249.8%, any morphine compound increased 161.8%, and any oxycodone-containing compound increased 267.3%. Mentions of each of these three classes of opioids remained less than 2% of all total drug mentions per year for each year studied. Medical use of the selected opioid classes, as reported in the ARCOS database and measured by grams distributed, all increased substantially (fentanyl 151.2%, morphine 48.8%, oxycodone 347.9%). Conclusion. Using this method of analysis, the rates of drug abuse, and resultant morbidity secondary to the use of opioid analgesics, remain low in spite of the increase in medical use of these substances.

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