MADISON, N.J., July 26, 2016 /PRNewswire/ -- The majority
of American adults taking opioids and other commonly prescribed
medications use them in ways that put their health at risk,
including potentially dangerous combinations with other drugs,
according to a new study from Quest Diagnostics (NYSE: DGX), the
world's leading provider of diagnostic information services.
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 District of
Columbia between 2011 and 2015.
"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 Harvey W. Kaufman,
M.D., senior medical director, medical informatics, Quest
Diagnostics. "The CDC's recent recommendations to physicians to
carefully weigh the risks and benefits of opioid drug therapy are a
step in the right direction, but clearly more needs to be done to
address this public health crisis."
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.
The Quest Diagnostics Health Trends™ report, Prescription Drug
Misuse in America 2016, is available at
QuestDiagnostics.com/trends
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, Quest Diagnostics, and a fellow of the
American Board of Forensic Toxicology.
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
National Institute on Drug Abuse shows that from 2001 to 2014,
there was a five-fold increase in the total number of deaths
related to benzodiazepines.
In March 2016, the Centers for
Disease Control and Prevention issued final guidelines recommending
that clinicians consider opioid therapy only if expected benefits
for both pain and function are anticipated to outweigh risks to the
patient, and that healthcare providers perform drug tests on their
patients prior to starting (baseline) and periodically during
opioid drug therapy as "urine drug tests can provide information
about drug use that is not reported by the patient."
Study Strengths and Limitations
The 2016 report is the
fifth Prescription Drug Monitoring Report from Quest Diagnostics
Health Trends™, the medical informatics unit of Quest Diagnostics,
examining patterns and trends observed from prescription drug
testing data performed by Quest Diagnostics laboratories. Previous
reports have focused on marijuana, misuse by adolescents, and
detecting heroin use.
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. Quest Diagnostics does not
provide services to all clinicians in the U.S., so results are not
broadly representative of all patients taking prescription
medications in the U.S. It is also possible some clinicians tested
patients due to appropriate suspicions of drug misuse, and that
some clinicians omitted to specify all drugs prescribed for the
patient on a test order, skewing some 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 Western
Institutional Review Board.
About Quest Diagnostics Health Trends™
Quest
Diagnostics manages the largest database of de-identified clinical
laboratory data, based on 20 billion data points from clinical lab
testing. From this data, the company derives clinically significant
insights that enable public health, policy makers and healthcare
practitioners take actions to improve the health care of Americans.
Developed in collaboration with top researchers and institutions
that include the Centers for Disease Control and Prevention
(CDC), Rockefeller University and UCSF, Quest Diagnostics
Health Trends studies are published in peer-reviewed medical
journals and by the company as a public service. Quest Diagnostics
Health Trends reports have yielded novel insights to aid the
management of allergies and asthma, chronic kidney disease,
diabetes, heart disease, influenza, prescription drug misuse and
wellness. Visit QuestDiagnostics.com/HealthTrends
About Quest Diagnostics
Quest Diagnostics empowers
people to take action to improve health outcomes. Derived
from the world's largest database of clinical lab results, our
diagnostic insights reveal new avenues to identify and treat
disease, inspire healthy behaviors and improve health care
management. Quest annually serves one in three adult
Americans and half the physicians and hospitals in the United States, and our 44,000 employees
understand that, in the right hands and with the right context, our
diagnostic insights can inspire actions that transform lives.
www.QuestDiagnostics.com
Quest, Quest Diagnostics, and all associated Quest Diagnostics
registered or unregistered trademarks are the property of Quest
Diagnostics. All third-party marks are the property of their
respective owners.
Contacts:
Wendy Bost,
Quest Diagnostics (Media): 973-520-2800
Shawn Bevec, Quest Diagnostics
(Investors): 973-520-2900
Logo - http://photos.prnewswire.com/prnh/20150422/200883LOGO
To view the original version on PR Newswire,
visit:http://www.prnewswire.com/news-releases/one-in-two-american-adults-misuse-their-prescription-drugs-finds-analysis-of-more-than-three-million-lab-tests-from-quest-diagnostics-300304099.html
SOURCE Quest Diagnostics