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Study shows America’s opioid epidemic began in the pharmacy

As Bloomberg puts it so succinctly, most of us have known for a long time that the opioid crisis began with the writing of a prescription.

Now, there is research that backs up the numbers and how people with chronic pain commonly received services related to drug use disorders and mental disorders in the last year of life, increasing their risk of death from respiratory depression. According to a press release on Tuesday, the “largest study of opioid deaths” was published in the American Journal of Psychiatry.

Study has two takeaways
Researchers delved into the medical records of 13,089 adults, all under the age of 65, in Medicaid programs in 45 states, who died of an opioid overdose between the years 2001 and 2007. The findings of the study can split the current opioid epidemic into two groups – those who were diagnosed with chronic pain and those who weren’t.

In the year before they died, about two-thirds (61.1 percent) were diagnosed with chronic pain and prescribed opioids. The remaining one-third had not had a diagnosis of chronic pain and became addicted to opioids in another way. Of the larger group, many had also been given prescriptions for anti-anxiety drugs called benzodiazepines, which, when taken together with opioids, can cause respiratory depression, often leading to death.

Dr. Mark Olfson, one of five researchers who conducted the massive study of the crisis and its causes, said in a telephone interview with Bloomberg, “Those are different populations. Understanding those things puts us in a better position to combat the epidemic.” In other words, those who suffer from chronic pain and are diagnosed with depression, anxiety or alcohol abuse, are at far greater risk from opioid-related death.

Dr. Olfson also points out that “In the years since there has been an increase in the proportion of US overdose deaths involving benzodiazepines and opioids.” The study authors hope this will alert lawmakers and health care providers to those at highest risk, as well as the dangers of prescribing opioids and benzodiazepines simultaneously.

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Other researchers in the study included Melanie Wall (CUMC), Shuai Wang (CUMC), Stephen Crystal (Rutgers, the State University of New Jersey, New Brunswick, NJ), and Carlos Blanco (National Institute on Drug Abuse, Rockville, MD).

The study, Service Use Preceding Opioid-Related Fatality, was published Tuesday in the American Journal of Psychiatry.

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