National illicit-drug use rose by 9% in 2009, say feds

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Pharmaceutical CommercePharmaceutical Commerce - September/October 2010

NSDUH survey shows prescription drug abuse rose by 13%, to 7.0 million individuals

The annual National Survey on Drug Use and Health (NSDUH) finds that overall drug abuse rose from 8.0% of the population aged 12 and older to 8.7% in 2009, driven primarily by increases in marijuana use. However, abuse of psychotherapeutics (which includes prescription pain relievers, tranquilizers, stimulants and sedatives) rose even faster, growing from 2.5% of the population to 2.8%, representing 7.0 million individuals. Among individuals with illicit-substance dependence or abuse that is medically classifiable, “nonmedical” use of prescription pain pills is the second-largest category, with 1.9 million individuals, as compared with 4.3 million marijuana abusers, and 1.1 million cocaine abusers.

There are implications in this for many manufacturers and distributors of CNS drugs generally and pain drugs specifically. The latter are dealing with FDA’s evolving plan for Risk Evaluation and Mitigation Strategies (REMS) for extended-release versions of opioids. For its part, the Drug Enforcement Administration has made life complicated for several major wholesalers (most recently, HD Smith) who aren’t, in DEA’s view, tracking their customers’ purchases of controlled substances closely enough.

Overall drug-abuse statistics had been trending downward over the past several years, according to the Substance Abuse and Mental Health Administration (SAMHSA), a department of HHS, which sponsors the National Survey. In noting increases in drug abuse among under-25 individuals, SAMHSA Administrator Pamela Hyde, JD, said, “These results are a wake-up call to the nation. Our strategies of the past appear to have stalled out with generation ‘next.’ Parents and caregivers, teachers, coaches, faith and community leaders, must find credible new ways to communicate with our youth about the dangers of substance abuse.”

Prescriber sourcing

The NSDUH, which is generated by face-to-face interviews of nearly 70,000 noninstitutionalized individuals across the country, including questions on sources of abused prescription drugs. For pain relievers specifically, 55.3% of respondents obtained the drugs “from a friend or relative for free.” Another 9.9% bought them from a friend or relative; 5.0% took them from a friend or relative without asking, and 17.6% obtained them from a prescription from one doctor. Only 4.8% purchased them from “a drug dealer or other stranger.” Further, 80% of the friends or relatives who had been the source of the abused pain drug obtained that drug via a prescription from one doctor.

Some preliminary data (which will be added to in coming months) from SAMHSA shows the scope of what is essentially a rapidly evolving new category of therapy: substance abuse treatment. There were 23.5 million individuals in need of specialized treatment for a substance-abuse problem; but only 2.6 million (11.2% of the group) were actually receiving that treatment.

As in previous years, the 2009 NSDUH shows a vast disparity between the number of people needing specialized treatment for a substance abuse problem and the number who actually receive it. According to the survey, 23.5 million Americans aged 12 or older (9.3 percent of this population) need specialized treatment for a substance abuse problem, but only 2.6 million (or roughly 11.2 percent of them) receive it.

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