The number of opioid prescriptions in the U.S. has dropped for the first time in two decades, according to a New York Times analysis of prescription drug data.
The reduced rate of prescriptions is the first drop since OxyContin hit the market in 1996.
Experts credit the change to education efforts and more stringent regulation at the state and federal level. In particular, doctors who routinely prescribed opioid painkillers have learned more about the dangers of opioids, and the risk of addiction in the patients they prescribe them to.
“The culture is changing,” University of Washington drug safety researcher Bruce Psaty told the Times. “We are on the downside of a curve with opioid prescribing now.”
The number of prescriptions for opioids -- a class of drug that includes OxyContin, Vicodin, morphine and other strong painkillers -- peaked in 2012, according to IMS Health, a firm that tracks prescription data in the U.S. Since then, prescriptions are down in 49 out of 50 states, and overall there are 18 percent fewer prescriptions than there were at the peak of the epidemic, according to medical data company Symphony Health Solutions. South Dakota is the only U.S. state in which opioid prescriptions have increased over the past three years.
While the number of prescriptions is down, overdose deaths are not, the paper noted.
There were 47,055 overdose deaths attributed to opioids in 2014, the most recent year for which complete statistics are available, according to the Centers for Disease Control. Drug overdoses are now the leading cause of accidental deaths in the U.S, per the American Society of Addiction Medicine.
That 47,055 number is a record in the U.S., according to the CDC. One of the reasons overdoses have not decreased in proportion to prescriptions is that many opioid abusers switch to abusing heroin if they can no longer obtain painkillers.
“The increasing number of deaths from opioid overdose is alarming,” CDC Director Tom Frieden said in December 2015, when the statistics were released. “The opioid epidemic is devastating American families and communities."
Hardliners like Dr. Nora Volkow of the National Institute on Drug Abuse say the government still isn't doing enough to curb abuse, despite states like New York implementing real-time, networked databases that prevent patients from doctor shopping or forging prescriptions.
Volkow told the Times opioids need to be further regulated, despite making it difficult for legitimate users of opioid medication -- like cancer patients and sufferers of chronic pain -- to fill genuine prescriptions.
“The urgency of the epidemic, its devastating consequences, demands interventions that in some instances may make it harder for some patients to get their medication,” Volkow said. “We need to set up a system to make sure they are covered. But we cannot continue the prescription practice of opioids the way we have been. We just can’t.”
Others say patients are better educated, and take it upon themselves to refuse opioid medication for minor procedures like dental work.
“It used to be that people would come in and sometimes be quite insistent” about getting opioid prescriptions, said Dr. Wanda Filer, the president of the American Academy of Family Physicians. But in the past year or two, she said, “I think we’ve seen some dampening of that effect. It’s all anecdotal, but I’m hearing it state by state, all around.”