The Percentage Of Long-Term Opioid Users Has Nearly Doubled Since 1999

And the causes are many.

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There’s no shortage of devastating statistics out there about America’s opioid crisis. For example, from 2007 to 2012, 780 million opioid pills were shipped to West Virginia alone. Or that half of unemployed men in the U.S. are on some sort of opioid pain pill. Or that since its 1996 launch, OxyContin, America’s most-used opioid, has made an estimated $31 billion in sales. Or that every day, 91 Americans die from opioid overdose.

Here’s another one: According to a new study by Dr. Ramin Mojtabai, a public health professor at Johns Hopkins, the percentage of American prescription opioid users who are classified as “long-term”—meaning on a drug for 90 days or longer—nearly doubled from 1999-2000 to 2013-2014.

Published in Pharmacoepidemiology and Drug Safety this week, the paper drew from data on more than 47,000 adult participants in a national health survey. Just 45.1 percent of people using prescription opioids were long-term users at the turn of the century, he found. A decade and half later, that number had reached 79.4 percent. The overall prevalence of prescription opioid use—defined as having taken it in the past 30 days—also rose, from 4.1 percent to 6.8 percent of U.S. adults.

These increases probably have a mixture of causes, Mojtabai tells Thrive Global. “The trend may reflect a change in practice style of physicians who may have become more attentive to complaints of pain and may have a lower threshold for prescribing opioids for management of pain than in the past,” he says. The campaign for doctors to take “pain as the fifth vital sign” (after body temperature, pulse, breathing rate, and blood pressure) may also explain the surge in prescribing painkillers, he says, as well as the advertising of pharmaceuticals to directly to consumers.

Mojtabai was careful to note that the opioid crisis is mainly driven by illicit (i.e. not prescription) use—in 2016, an estimated two million Americans had a substance use disorder involving opioid pain relievers. Nonetheless, long-term use of prescriptions opioids is associated with developing a tolerance for them, misuse and the chance of escalating doses. Prescribing opioids along with benzodiazepines like Xanax increases the chance for overdose, too. Thankfully, effective treatment options for opioid abuse do exist, and they do work. While it might seem like the pain pill crisis about physical pain, sociologists say that there are economic—and even emotional or spiritual—factors at play, too. 

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