Lessons learned in the abuse of pain-relief medication: a focus on healthcare costs

Figures & data

Figure 1. Global morphine consumption in 2007.

Data taken from International Narcotics Control Board, United Nations Data. Graphic created by the Pain and Policy Study Group, University of Wisconsin/WHO Collaborating Center (2009).

Figure 2. Opioid-related deaths, 1999–2010 in all categories.

Data taken from [33].

Figure 3. Deaths from unintentional drug overdoses in the USA according to major type of drug, 1999–2007.

Adapted with permission from [211].

Figure 4. Rates^† of opioid pain reliever overdose deaths, opioid pain relief treatment admissions and kilograms of opioid pain relievers sold – USA, 1999–2010.

^†Age-adjusted rates per 100,000 population for OPR deaths, crude rates per 10,000 population for OPR abuse treatment admissions and crude rates per 10,000 population for kilograms of OPR sold.

OPR: Opioid pain reliever.

Adapted with permission from [33].

Figure 5. Annual societal costs of opioid abuse, dependence and misuse in the USA, 2007.

Adapted with permission from [218].

Figure 6. Percentage of patients and prescription drug overdoses, by risk group in the USA.

Adapted with permission from [41].

Figure 7. Guidance to opioid therapy.

CT: Computed tomography.

Adapted with permission from [5].

Table 1. Retail sales of opioid medications (grams of medication) from 1997 to 2007.

Drug	1997	1998	1999	2000	2001	2002	2003	2004	2005	2006	2007^‡	% change from 1997 to 2007
Methadone	518,737	692,675 (34%)	964,982 (39%)	1,428,840^† (48%)	1,892,691 (32%)	2,649,559 (40%)	3,683,881 (39%)	4,730,157 (28%)	5,362,815 (13%)	6,621,687 (23%)	7,228,219 (9%)	1293
Oxycodone	4,449,562	6,579,719 (48%)	9,717,600 (48%)	15,305,913 (58%)	19,927,286 (30%)	22,376,892 (12%)	26,655,152 (19%)	29,177,530 (9%)	30,628,973 (5%)	37,034,220 (21%)	42,977,043 (16%)	866
Fentanyl base	74,086	90,618 (22%)	107,141 (18%)	146,612^† (37%)	186,083 (27%)	242,027 (30%)	317,200 (31%)	370,739 (17%)	387,928 (5%)	428,668 (11%)	463,340 (8%)	525
Hydromorphone	241,078	260,009 (8%)	292,506 (12%)	346,574^† (18%)	400,642 (16%)	473,362 (18%)	579,372 (22%)	655,395 (13%)	781,287 (19%)	901,663 (15%)	1,011,028 (12%)	319
Hydrocodone	8,669,311	10,389,503 (20%)	12,101,621 (16%)	14,118,637 (17%)	15,594,692 (10%)	18,822,619 (21%)	22,342,174 (19%)	24,081,900 (8%)	25,803,543 (7%)	29,856,368 (16%)	32,969,527 (10%)	280
Morphine	5,922,872	6,408,322 (8%)	6,804,935 (6%)	7,807,511 (15%)	8,810,700 (13%)	10,264,264 (16%)	12,303,956 (20%)	14,319,243 (16%)	15,054,846 (5%)	17,507,148 (16%)	19,051,426 (9%)	222
Codeine	25,071,410	26,018,054 (4%)	23,917,088 (-8%)	23,474,865^† (-2%)	23,032,641 (-2%)	22,633,733 (-2%)	21,865,409 (-3%)	20,264,555 (-7%)	18,960,038 (-6%)	18,762,919 (-1%)	18,840,329 (0.4%)	-25
Meperidine (Pethidine)	5,765,954	5,834,294 (1%)	5,539,592 (-5%)	5,494,898^† (-1%)	5,450,204 (-1%)	5,412,389 (-1%)	5,239,932 (-3%)	4,856,644 (-7%)	4,272,520 (-12%)	4,160,033 (-3%)	3,936,179 (-5%)	-32
Total	50,713,010	56,273,194 (11%)	59,445,465 (6%)	35,962,089.84 (15%)	75,294,939 (11%)	82,874,845 (10%)	92,987,076 (12%)	98,456,163 (6%)	101,251,950 (6%)	115,272,706 (14%)	126,477,091 (10%)	149

Number in parentheses is percentage of change from previous year.

^†For year 2000, data are not available, the average of 1999 and 2001 was taken.

^‡Data for the year 2007 was taken from [224].

Data taken from [225].

Activity Evaluation: Where 1 is strongly disagree and 5 is strongly agree

	1	2	3	4	5
1. The activity supported the learning objectives.
2. The material was organized clearly for learning to occur.
3. The content learned from this activity will impact my practice.
4. The activity was presented objectively and free of commercial bias.

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