An analysis of national prescribing patterns shows that more than half of patients who received an opioid（阿片样物质） prescription¹ in 2009 had filled another opioid prescription within the previous 30 days. This report also suggested potential opportunities for intervention² aimed at reducing abuse of prescription opioids. Researchers from the National Institute on Drug Abuse (NIDA), a component³ of the National Institutes of Health, will publish results of this analysis in this week's Journal of the American Medical Association (JAMA).

"More research is needed to see if current practices are working, with a closer look at why so many patients are getting multiple prescriptions⁴ within a short period of time," said NIDA Director Nora D. Volkow, M.D. "As a nation, it is important that we all become better informed about effective pain management and the risks of abusing prescription painkillers⁶."

This analysis comes on the heels of a nearly 20 year increase in the use of prescription painkillers. From 1991 to 2009, prescriptions for opioid analgesics⁸ increased almost threefold, to over 200 million. According to the Drug Abuse Warning Network system, which monitors drug-related emergency department visits and drug-related deaths, emergency room visits related to the nonmedical use of pharmaceutical⁹ opioids has doubled between 2005 and 2009. While these medications are crucial for pain management, their wide availability may also result in leftover¹⁰ pills in family medicine cabinets, increasing opportunities for abuse, as well as a host of serious medical consequences, including addiction¹¹. Most abusers report getting these medications from friends and relatives who had been prescribed opioids, or they are abusing their own medications.

This study used data from SDI's Vector One National database, a privately¹² owned national-level prescription and patient tracking service. The sample included 79.5 million prescriptions dispensed¹³（分发，执行） in the United States during 2009, which represent almost 40 percent of all the opioid prescriptions filled nationwide. They broke down the prescriptions by physician specialty¹⁴, patient's age, duration of prescription, and whether or not the patient had previously¹⁵ filled a prescription for an opioid analgesic⁷（止痛剂） within the past 30 days. The researchers looked at prescribing practices for younger patients, who are more at risk than older adults for opioid abuse and later addiction.

The records show that approximately 56 percent of painkiller⁵ prescriptions were given to patients who had filled another prescription for pain from the same or different providers within the past month. In addition, nearly 12 percent of opioids prescribed were to young people aged¹⁶ 10-29. Most of these were hydrocodone- and oxycodone-containing products, like Vicodin and Oxycontin. Dentists were the main prescribers for youth aged 10-19 years old. Nearly 46 percent of opioid prescriptions were given to patients between ages 40 and 59, and most of those were from primary care providers.

The current issue of JAMA also includes an accompanying commentary from Dr. Volkow and Dr. Thomas McLellan of the University of Pennsylvania School of Medicine. They point out that according to the Centers for Disease Control and Prevention, prescription opioid overdose is now the second leading cause of accidental death in the United States, killing¹⁷ more people than heroin¹⁸ and cocaine¹⁹ combined. They also state that this is compelling evidence for the need to develop smart strategies to curtail²⁰ abuse of opioid analgesics, without jeopardizing²¹ pain treatment.

The analysis can inform policy makers²² wanting to implement²³ systems to reduce opioid abuse. Already many states are looking at prescription drug monitoring programs that will give physicians access to information on prescriptions previously received by their patients.