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10/ accessHealthnews.net Fall/Winter 2013 Deadly Meds Overdose deaths trump heroin & cocaine combined By Jennifer Foster Many people equate drug use, addicts and overdoses to illegal street drugs. Drugs like heroine, cocaine, methamphetamine and ecstasy are the ones we hear about most. But what if the current drug epidemic in America was happening at home, right in the medicine cabinet? Today, the number of overdose deaths from legal medications are rivaling illegal substances. In fact, statistics show that approximately 6.1 million Americans will abuse prescription medications this year, according to the Robert Wood Jones Foundation (RWJF). Included in this number will be America's youth. A CDC study found that one out of every five teens in the U.S. will abuse a prescription drug at some time. Deaths by prescription drug overdose are escalating. Since 1999, the number of Americans who have died from prescription drug overdose has quadrupled, and now outnumbers overdose deaths caused by both heroine and cocaine combined. While illegal street drugs are still considered more dangerous, claiming a higher percentage of overdoses, the raw numbers are still higher among prescription drug users. Darrel Box, Rph, CEO of Lafayette Regional Health Center in Lexington, MO, said there are more deaths from prescription drugs than from heroin and cocaine because more people take prescription drugs than use illegal drugs. "Eighty percent of the patients on opioids (pain killers) are on low doses, less than 100 mg of morphine equivalent per day, account for about 20 percent of overdoses," Box said, "On the other hand, 10 percent of patients who 'doctor-shop' are on greater than 100 mg per day and account can be an indicator of someone for 40 percent of overdoses." who may be 'shopping.'" In a single day, RWJF estimates that about 50 Americans will die from prescription drug overdoses. This is nearly double the number of people killed daily in the U.S. by drunk drivers. "For the patient that abuses prescription medications, they have become pretty adept at avoiding the safeguards put into place," Box said. "They will shop for a doctor and pharmacy. As a provider, being vigilant about patients that are coming from outside your normal service area Box added that minimizing the risk of overdose will require continuing education about prescription drug abuse, as well as potentially having patients on chronic medication submit to urine drug screens. Box also recommends requiring functional capacity testing to help minimize the risk that the patient will be harmed by use of prescription medication, while weeding out patients who are seeking pharmaceuticals for nontherapeutic use. "It is also important that patients utilize the same providers and pharmacies to help ensure their safety," Box said. "This includes giving them an accurate history so they are aware of all medicines and supplements that a patient takes. This allows them to make sure there are no interactions between the products that could pose health risks." Box also stressed the importance of having a medical home. "Coordination of care, as one would expect to see in a medical home model, should decrease the risk of adverse medical outcomes."