Online Program

Prescription Opioid Epidemic: Current Trends, Analysis, and Interpretation (309703)

Presentation

*Thomas Bryan, BGD 
Simeon Chow, CURA Consulting 
Richard K Thomas, RKT 

Keywords: Opioid Epidemic, Opioid Use Disorder, Prescription Drug Abuse

We provide a synthesis of CDC, SAMHSA’s NSDUH and IQVIA Xponent prescription pain reliever (hereafter Rx PR) data with our own research and analysis to comprehensively assess the most recent changes in the opioid epidemic.

The misuse of opioids in the United States has exploded into an epidemic since the mid-1990s, resulting in a cumulative 450,000 deaths in three broad waves from 1999 through 2018. Given the evolution of this epidemic, and the acuteness of the turns it has taken, we believe current analysis, reporting and understanding are both dated and inadequate. Using the National Survey of Drug Use and Health (NSDUH), we show an increase in opioid misuse from 2002-2014, and a subsequent drop in 2015 (due to a change in the NSDUH opioid misuse question) - followed by a downward trend from 2015 through 2019. This is contrary to both our rigorously developed forecasts and current conventional thinking. Why? Using opioid prescription data from IQVIA (Xponent 2006–2018) we show a reversal of Rx PR prescription rates around 2012 – when misuse peaked, and just prior to the decline in Rx PR misuse in 2015. In this context, reductions in Rx PR prescription rates appear to have preceded reductions in misuse, which in turn have preceded reductions in Rx PR opioid-related overdose deaths in 2017-2018.

As of this writing, in the midst of COVID-19, the US has just witnessed more than 76,000 people dying of a drug overdose between April 2019 and April 2020 - the most ever recorded during a 12-month period. This almost certainly portends a “4th Wave” by the CDC and underscores the urgency and importance of independent expertise and understanding of the epidemic.

We consider alternate analytic interpretations to develop and broaden an understanding of current trends and of Rx PR patient progression to abuse. This more fulsome understanding of the epidemic and human behavior could lead to more efficient and effective initiatives to manage this crisis.