Ever since I began following the painkiller crisis, I wondered if anyone knew the percentage of prescription narcotics that end up on the black market. A leading researcher recently told me that she knows of no comprehensive study of this, but she thinks the data is out there, if someone could find funding to analyze it.
A scholarly paper published this week seeks to partially answer this question by studying doctor-shoppers — individuals who received opioid prescriptions from multiple doctors, an indication that the drugs were for illicit use. From the press release:
Although they constituted a small portion of patients prescribed opioids, (doctor-shoppers) purchased an estimated 4.3 million prescriptions, or almost 2 percent of all prescriptions for highly controlled opioids, amounting to about 4 percent of all opioids by weight.
The individuals in the study received an average of 32 prescriptions (throughout the year) from 10 different doctors.
But that’s just doctor-shoppers. What about all the people who went to only one pill mill but received huge doses? (During the year under review, 2008, the number of pill mills in south Florida began to explode, going from a handful to hundreds.) What about drugs stolen from pharmacies or individual medicine cabinets, or legitimate prescriptions that were given away when the pain faded? The total number of opioids that wind up being abused must be significantly higher than 4 percent.
Here are a couple of numbers that might give a better sense of the totality of diversion: according to this Wall Street Journal story, the sales of OxyContin fell more than 10% after its maker introduced an abuse-deterrent version in 2010. Last year, sales of newly abuse-deterrent Opana fell 25 percent.