April 20--Patients got fewer narcotic painkillers and overdoses declined after two problem drugs were removed from the market in 2010, a large study of insurance claims reported Monday.
The researchers looked at changes in the use of painkillers after manufacturers stopped producing propoxyphene and the original form of OxyContin. Propoxyphene, sold as Darvon, was removed because of concerns about heart problems, and OxyContin was replaced with a tamper-resistant version because the original pill was easy for addicts to crush and snort or inject for a heroin-like high.
The use of narcotic painkillers -- along with deaths involving them -- had increased steeply in the years leading up to the removal of the two drugs.
The researchers analyzed a decade's worth of insurance claims for more than 31 million people to assess the impact of the removals. They looked at the total amount of narcotic painkillers dispensed and the number of nonfatal overdoses treated in emergency rooms and hospitals.
They found that the rate at which narcotic painkillers were dispensed was 19% lower than would have been expected had the previous trend continued, the study found. In addition, the rate of overdoses involving prescription painkillers was 20% lower than would have been expected.
However, heroin overdoses rose -- suggesting users may be substituting the illegal narcotic for a prescribed one.
"This is the first study to demonstrate a reversal in previously unrelenting increases in opioid dispensing on a national scale," the researchers wrote in a study published online Monday by JAMA Internal Medicine.
The insurance claims data did not indicate how many of the overdoses resulted in death. Statistics gathered by the government show that such overdoses claim more than 16,000 lives a year -- a toll the Centers for Disease Control and Prevention has called an epidemic.
The new study supports the notion that a reduction in the use of narcotic painkillers may reduce overdoses, new cases of addiction and other hazards. That idea has led to programs across the country that enable physicians in offices and emergency rooms to monitor and limit patients' use of narcotics.
Restricting the use of painkillers may decrease new addictions, the researchers wrote.
But, "it will not cure existing addiction," they conclude. "Further efforts are needed to improve identification and treatment of these individuals."
