Many Americans appear to be misusing their prescription drugs in ways that put their health at risk, notably combining dangerous combinations of medicines, according to a report released this week.
The rate at which drugs were misused was 54 percent last year, according to the (*1) new analysis of more than 3.1 million de-identified laboratory test results. This was down from 63 percent in 2011, although the findings were quite similar to what was found in 2013 and 2014, according to Quest Diagnostics, the laboratory testing company, which conducted the analysis.
The analysis combed through test results for inconsistencies, such as a patients taking medicines with other drugs for which they don’t have prescriptions, or if they were skipping doses. Of the tests indicating misuse, about 45 percent showed evidence that patients mixed medicines, which the lab company interpreted as a sign that a “sizable” number of patients might be using dangerous drug combinations.
Notably, this finding was much higher than in previous years — there was evidence that drugs were inappropriately mixed in 32 percent of the 2011 lab tests and 35 percent of the 2014 tests. Quest said the most recent results are significant because combinations of certain drugs — notably, opioids, and sedatives — can cause dangerous interactions, such as severe respiratory depression, coma, and death.
“The discovery that a growing percentage of people are combining drugs without their physician’s knowledge is deeply troubling, given the dangers,” said F. Leland McClure III, Quest’s medical affairs director, in a statement. “Perhaps patients do not understand that mixing even small doses of certain drugs is hazardous, or they mistakenly believe prescription medications are somehow safe.”
On the bright side, test results for children between the ages of 10 and 17 showed rates of inconsistent prescription drug use of 44 percent last year, a sharp drop from 70 percent in 2011. There was also a decline among children younger than 10 years old, falling to 31 last year from 34 percent in 2014. Quest speculated this may reflect greater oversight by parents or guardians.
Here are some other interesting findings:
Among the youngest patients — those younger than 10 — amphetamines were associated with the most inconsistent results, followed by benzodiazepines and methylphenidate, which is the generic name for Ritalin. Quest rightfully noted that these stimulants are frequently prescribed to treat children who are diagnosed with attention deficit hyperactivity disorder.
Among those 25 and older, benzodiazepines had the highest number of inconsistent test results, while in patients 18 and up, opiates generated the second-largest number of inconsistent results. “The misuse of opioids is especially troubling due to risk of harm or potentially fatal overdose that is associated with concurrent use of benzodiazepine drugs and other central nervous system depressants,” Quest wrote.
The percentage of test results showing inconsistent medicine use — and absolutely no trace of any prescription drug — fell to 32 percent last year from 40 percent in 2011. Why might this happen? Well, a patient may not take a prescribed drug as directed or simply stop due to side effects, a belief their affliction has ended, or a lack of funds. Quest also posited that some folks sell their meds for money.
Meanwhile, patients with hepatitis C tested positively for additional, nonprescribed drugs more frequently than people who did not have the chronic virus — 66 percent compared with 51 percent. And hepatitis C patients also showed evidence of using painkillers that were not prescribed, as well as heroin, at a far higher rate than those without the disease.
*1) Chrome Extension: Prescription Drug Monitoring 2016.pdf
By Ed Silverman - PBS/July 30, 2016
Illustration: Wes Watson, Star Tribune