One-third of Americans who have taken prescription opioids for at least two months say they became addicted to, or physically dependent on, the powerful painkillers, according to a new Washington Post-Kaiser Family Foundation survey.
Virtually all long-term users surveyed said they were introduced to the drugs by a doctor’s prescription, not by friends or through illicit means. But more than 6 in 10 said doctors offered no advice about how or when to stop taking the drugs. And 1 in 5 said doctors provided insufficient information about the risk of side effects, including addiction.
The survey raises sharp questions about the responsibility of doctors for an epidemic of addiction and overdose that has killed nearly 180,000 people since 2000. Opioid deaths surged to more than 30,000 last year, according to new data from the U.S. Centers for Disease Control and Prevention, with deaths from heroin alone surpassing the toll from gun homicides.
Doctors have been widely blamed for sparking the crisis by overprescribing highly addictive opioids to treat everyday pain. The survey suggests that they are still doing too little to stop it.
“Why isn’t it 100 percent?” demanded Gary Mendell, founder of Shatterproof, a grass-roots group dedicated to reducing addiction in the United States, referring to the share who say doctors have counseled them on stopping the medication. “It’s unbelievable that it’s not 100 percent.”
Patrice A. Harris, chairwoman of the American Medical Association’s Board of Trustees and chairwoman of its task force to reduce opioid abuse, acknowledged that doctors could do more to counsel patients on avoiding addiction.
“The doctors that I have talked to are discussing this with their patients,” Harris said. But, citing the survey, she added: “We could certainly do a better job.”
Despite the high rate of dependence, the poll finds that a majority of long-term opioid users say the drugs have dramatically improved their lives. Opioids relieve pain that is otherwise intractable, they said in follow-up interviews, allowing them to walk, work and pursue other activities. Fully two-thirds of users surveyed said relief is well worth the risk of addiction.
People living with opioid users tend to have a darker view of the drugs’ effects. While one-third of users say they are hooked, more than half of people living with them suspect addiction, the survey found. Family members are also far more likely to say the drugs have damaged the users’ physical and mental health, finances and personal relationships.
Still, the survey’s findings highlight a fundamental conflict: While the drugs are a scourge for many, they are a godsend to others, especially the estimated 100 million Americans who live in chronic pain. Efforts by policymakers to restrict use have been met with outrage.
“We’re not saying that no one should ever be on these pills,” but most people would be “healthier and more functional if they were off them,” said CDC Director Tom Frieden, who this spring urged doctors to sharply limit the number of pills they prescribe.
“The bottom line here is that prescription opiates are as addictive as heroin. They’re dangerous drugs,” Frieden said. “You take a few pills, you can be addicted for life. You take a few too many and you can die.”
Opioid abuse – both prescription painkillers and their chemical cousins, heroin and fentanyl – is the main cause of rising death rates among middle-aged white Americans, particularly women in rural areas. It also has contributed to the first overall decline in U.S. life expectancy at birth in more than two decades, the government reported Thursday.
In 2014, U.S. doctors wrote 240 million prescriptions for opiates, enough for every adult to have their own bottle of pills. The CDC estimated that about 2.1 million Americans are addicted to legal narcotics.
In the first-ever guidelines on opioids for physicians, the CDC in March urged doctors to try nonnarcotic methods before offering patients pills containing oxycodone, hydrocodone and other opioids. The guidelines noted that there is little evidence that opioids are effective beyond 12 weeks.
“Three days or less will often be sufficient; more than seven days will rarely be needed,” the guidelines say.
But many people take the drugs much longer. In the past two years, about 5 percent of American adults have used prescription opioids for at least two months, the poll found; about half of those report taking the drugs for two years or more.
