Suboxone.com - Opioid Dependence in the United States

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IMPORTANT INFORMATION:

On December 8, 2006, Federal legislation was passed allowing physicians to treat up to 100 opioid dependent patients with Suboxone at any given time—a significant increase from the previous limit of 30 patients.

There may be doctors in your area participating in a study to measure opioid dependence treatment outcomes. Patients who meet the eligibility requirements to participate in this study can receive up to $225 in compensation to complete surveys about their treatment.

NOTE: This study is only open to patients not currently under the care of a physician for opioid dependence and are seeking a treatment provider.

Please call 1-866-455-8876 between 9:00 AM to 7:30 PM EST to get more information.

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Opioid Dependence in the United States

Over the past decade, the use of opioids, such as prescription painkillers and heroin, has grown significantly.¹ As the use of opioids increases, so does the number of people who abuse or become dependent on them. According to the National Survey on Drug Use and Health (NSDUH), in 2003 more than 1.5 million people were dependent on or abusing prescription painkillers or heroin.¹

(NOTE: Other surveys calculated the heroin-dependent population to be 4 to 5 times larger than what was reported in the 2003 NSDUH. Using these numbers, the size of the opioid abusing/dependent population in the United States is between 2.2 million and 2.4 million—or slightly bigger than the population of Houston, Texas.^1-3)

The problem of opioid dependence in this country is explored further in the sections listed below:

Prescription Painkillers—A Growing Presence
Opioid Use—The Changing Profile
Heroin—Hitting Closer to Home
Barriers to Treatment

Prescription Painkillers—A Growing Presence
Between 1990 and 2001, the number of people who used prescription painkillers recreationally for the first time grew by 335% to include almost 2.5 million people.¹

Annual Number of New Recreational Users of Prescription
Painkillers, Ages 12 and Older: 1970-2001¹

Over an 8-year period (1994-2002), emergency rooms saw a big jump in the number of admissions involving prescription painkillers, including:

Admissions involving oxycodone rose 450%⁴
Admissions involving hydrocodone rose 170%⁴

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Opioid Use—The Changing Profile
Through most of the 1980s, opioids were rarely used except when needed for medical reasons. The rising recreational use of drugs like marijuana and cocaine, for example, was considered much more important than the recreational use of opioids.¹

By the mid-1990s, however, the use of opioids for nonmedical reasons not only was increasing but also had become much more mainstream. This shift meant that new populations were now at risk, specifically, younger users^2,5:

44% of new recreational use of prescription painkillers in 2001 was by people under younger than age 18¹
The number of 18- to 25-year-olds admitted to treatment for prescription painkillers more than doubled between 1993 and 2002⁶

Frequency of Treatment Admissions for Prescription Painkillers
Among Persons Ages 18-25: selected years⁶

Women's use of opioids also has been increasing^5,7:

55% of new recreational users of prescription painkillers in 2001 were women¹
Between 1995 and 2002, the likelihood of a woman needing emergency medical care due to prescription painkillers doubled⁸

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Heroin—Hitting Closer to Home
Heroin has now spread to many communities where, until recently, it was virtually unheard of.^2,9,10 Even as heroin use falls in larger metropolitan areas, use in the suburbs continues to rise.^5,10,11

Heroin today is cheap and relatively pure—the national average is about 35% pure (compared with less than 5% pure during the 1960s and 1970s).^2,5,9,12 This purity increases heroin's appeal to new users, because¹²:

No needles—higher purity heroin can be smoked or snorted¹¹
Fewer obstacles—because smoking and snorting involve minimal preparation, they make it easier to use heroin "casually"^5,11-13
Fewer deterrents—many people unwilling to inject heroin are willing to snort or smoke heroin^5,11-13
Misinformation—many new users believe that heroin is less addictive when smoked or snorted^2,12

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Barriers to Treatment
Overall, opioid dependence accounted for 18% of all substance abuse treatment admissions in 2001, surpassing cocaine admissions for the 5th consecutive year.¹⁴

This figure is believed to understate the true size of the opioid dependence problem, because:

In several states, the number of people who want treatment is greater than the resources available to actually provide treatment¹⁵
The stigma attached to opioid dependence can be so overwhelming that thousands of patients every year choose to continue using opioids rather than risk possible exposure by receiving treatment^15,16
20% of patients who wanted help for substance abuse in 2001 did not seek treatment because of their fear of being stigmatized¹
Only about 15% of heroin-dependent persons are in treatment

As a result of these and other factors, in 2004, at least 1.2 million opioid-dependent patients in the United States are believed to be untreated.¹⁷

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References

1.	Substance Abuse and Mental Health Services Administration (SAMHSA). Results From the 2003 National Survey on Drug Use and Health: National Findings. Rockville, Md: Department of Health and Human Services, SAMHSA, Office of Applied Studies; 2004. NSDUH Series H—25, DHHS Publication No. SMA 04-3964.
2.	Stancliff S. Buprenorphine and the treatment of opioid addiction. The PRN Notebook. 2004;9:28-32.
3.	Infoplease. Population of the 20 largest U.S. cities. 1900-2003. Available at: http://www.infoplease.com/ipa/A0922422.html. Accessed April 6, 2005.
4.	SAMHSA. The DAWN Report: oxycodone, hydrocodone, and polydrug use, 2002. July 2004. Available at: http://www.oas.samhsa.gov/2k4/oxycodone/oxycodone.cfm. Accessed September 30, 2004.
5.	Community Epidemiology Work Group (CEWG). Advance report of findings presented at the 53rd CEWG meeting. Available at: http://www.drugabuse.gov/PDF/CEWG/AdvReport1202.pdf. Accessed September 30, 2004.
6.	SAMHSA. Quick Statistics From the Drug and Alcohol Services Information System. Available at: http://www.dasis.samhsa.gov/webt/tedsweb/tab_year.choose_year_web_table?t_state=US. Accessed October 19, 2004.
7.	Partnership for a Drug-Free America. Prescription medication abuse. Available at: http://www.drugfreeamerica.org/Templates/Prescription_Abuse.asp? ws=PDFA&vol=1&grp=Kids. Accessed August 10, 2004.
8.	SAMHSA. The DAWN Report: narcotic analgesics, 2002 update. September 2004. Available at: http://www.dawninfo.samhsa.gov/pubs_94_02/shortreports/files/DAWN_tdr_na2002.pdf. Accessed October 19, 2004.
9.	Klein A. Young and hooked: pure, cheap heroin luring more North Jersey teens. New Jersey Record. May 2, 2004:A-1, A-14-A-15.
10.	National Institute on Drug Abuse. Research Report series: heroin abuse and addiction. Printed October 1997. Reprinted September 2000. Available at: http://www.nida.nih.gov/ResearchReports/Heroin/Heroin.html. Accessed September 30, 2004.
11.	Epstein JF, Gfroerer JC. Heroin abuse in the United States. Office of Applied Studies, SAMHSA website. Available at: http://www.oas.samhsa.gov/NHSDA/Treatan/treana11.htm. Accessed July 29, 2004.
12.	California Department of Alcohol and Drug Programs. Fact sheet: facts and figures on youth heroin use. July 2004. Available at: http://www.adp.cahwnet.gov/FactSheets/Facts_and_Figures_on_Youth_Heroin_Use.pdf. Accessed September 30, 2004.
13.	Fiellin DA, O'Connor PG. Office-based treatment of opioid-dependent patients. N Engl J Med. 2002;347:817-823.
14.	Treatment Episode Data Set. 2001 Highlights. Available at: http://www.dasis.samhsa.gov/teds01/TEDS2K1High.htm. Accessed August 12, 2004.
15.	Ellen EF. Methadone proponents urge office-based treatment. Psych Times. January, 2001. Available at: http://www.medicineandbehavior.com/mb990801b.html. Accessed August 16, 2004.
16.	O'Connor A. New ways to loosen addiction's grip. The New York Times. August 3, 2004;sect F:1.
17.	Lucas GM. Buprenorphine in primary HIV care clinics: a big pill to swallow. The Hopkins HIV Report. 2004;16:5-7.