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|One in Two American Adults Misuse Their Prescription Drugs, Finds Analysis of More Than Three Million Lab Tests from Quest Diagnostics|
Believed to be the largest ever examination of prescription drug misuse patterns based on physician-ordered laboratory tests, the multi-year analysis of 3,143,739 de-identified test results revealed that 54 percent of patient results tested in 2015 showed evidence of drug misuse, slightly above the 53 percent misuse rate in 2014. While high, the misuse rate declined 14 percent from 63 percent in 2011. The study is based on results of patients tested in 49 states and the
"The key takeaway from this massive, nationally representative analysis is that despite some gains, a large number of patients use prescription drugs inappropriately and even dangerously," said co-researcher
Drug misuse is defined as evidence, based on lab test results, that a patient is using or combining non-prescribed drugs or skipping doses in a manner that is inconsistent with the ordering physician's directions. Quest's prescription drug monitoring test services help to identify evidence of use of up to 44 commonly misused prescription and illicit drugs, such as opioids, amphetamines, sedatives, and marijuana and heroin.
Growing Percentage of Patients Combine Drugs
The analysis also found that among patients whose test results showed evidence of prescription drug misuse, the percentage of those who combined their prescription medication with other drugs not known to the physician jumped sharply in recent years. In 2015, 45 percent of these patients had test results that showed evidence of one or more other drug(s) in addition to their prescribed drug(s). This compares to 35 percent in both 2014 and 2013, 33 percent in 2012, and 32 percent in 2011.
The findings are significant because combinations of certain drugs, such as opioids and sedatives, can result in potentially dangerous interactions, including severe respiratory depression, coma and death.
"For some patients, opioids and sedatives are co-prescribed which is of concern. The discovery that a growing percentage of people are combining drugs without their physician's knowledge is deeply troubling given the dangers. Perhaps patients do not understand that mixing even small doses of certain drugs is hazardous, or they mistakenly believe prescription medications are somehow safe," said co-researcher F Leland McClure III, PhD, medical affairs director,
One in Three Patients Taking Heroin Combined it With Benzodiazepines
About 1.6 percent of patients tested for heroin showed evidence of heroin use. Heroin use was detected across all age ranges in adults tested, including those above age 65, although it was most likely to be detected in patients 25-34 years of age (3.6% among those tested) and age 18-24 (3.24%). Men were tested for heroin less frequently than women, but had a positivity rate more than 50 percent higher than women (1.97% vs. 1.26%).
The Quest researchers also found that nearly one in three patients (28.6%) who used heroin combined it with benzodiazepines, a class of prescription psychoactive medications that includes tranquilizers such as Xanax and Valium. In 92 percent of these patients, the benzodiazepines were not prescribed by a physician, meaning an illicit combination of heroin and benzodiazepines.
Benzodiazepines can have strong sedative effects, including respiratory depression, when combined with alcohol, other sedatives, or illicit drugs – including heroin. Data from the
Study Strengths and Limitations
The study's strengths are its size and national scope; use of an objective laboratory method, versus surveys or polls, which may be subject to user misrepresentation or error; confirmation of all positive drug screens by mass spectrometry, the most advanced drug testing method; and for consistency rate analysis the inclusion of patients under care by clinicians in a primary care or pain-management setting, but exclusion of those in drug rehabilitation or addiction treatment settings, where unusually high rates of drug misuse may be expected.
Study limitations include geographic disparities; inability to confirm drug misuse through access to medical records or clinical evaluation; and technical factors and patient variations, such as drug metabolism and hydration state, that may affect the reliability of a minority of results.
The company's Quest Diagnostics Health Trends studies are performed in compliance with applicable privacy regulations, the company's strict privacy policies and as approved by the
About Quest Diagnostics Health Trends™
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