title: Trends in opioid analgesic abuse and mortality in the United States.
abstract: BACKGROUND
  The use of prescription opioid medications has increased greatly in the United States during the past two decades; in 2010, there were 16,651 opioid-related deaths. In response, hundreds of federal, state, and local interventions have been implemented. We describe trends in the diversion and abuse of prescription opioid analgesics using data through 2013.
  
  
  METHODS
  We used five programs from the Researched Abuse, Diversion, and Addiction-Related Surveillance (RADARS) System to describe trends between 2002 and 2013 in the diversion and abuse of all products and formulations of six prescription opioid analgesics: oxycodone, hydrocodone, hydromorphone, fentanyl, morphine, and tramadol. The programs gather data from drug-diversion investigators, poison centers, substance-abuse treatment centers, and college students.
  
  
  RESULTS
  Prescriptions for opioid analgesics increased substantially from 2002 through 2010 in the United States but then decreased slightly from 2011 through 2013. In general, RADARS System programs reported large increases in the rates of opioid diversion and abuse from 2002 to 2010, but then the rates flattened or decreased from 2011 through 2013. The rate of opioid-related deaths rose and fell in a similar pattern. Reported nonmedical use did not change significantly among college students.
  
  
  CONCLUSIONS
  Postmarketing surveillance indicates that the diversion and abuse of prescription opioid medications increased between 2002 and 2010 and plateaued or decreased between 2011 and 2013. These findings suggest that the United States may be making progress in controlling the abuse of opioid analgesics. (Funded by the Denver Health and Hospital Authority.).
authors.affiliation: From the Rocky Mountain Poison and Drug Center, Denver Health and Hospital Authority, Denver (R.C.D., S.G.S., B.B.-B., J.L.G.); the Center for Applied Research on Substance Use and Health Disparities, Nova Southeastern University, Ft. Lauderdale, FL (H.L.S.); the Department of Psychiatry, Washington University School of Medicine, St. Louis (T.J.C.); and the American Association for the Treatment of Opioid Dependence, New York (M.W.P.).
authors.forename: Richard C
authors.initials: RC
authors.lastname: Dart
authors.forename: Hilary L
authors.initials: HL
authors.lastname: Surratt
authors.forename: Theodore J
authors.initials: TJ
authors.lastname: Cicero
authors.forename: Mark W
authors.initials: MW
authors.lastname: Parrino
authors.forename: S Geoff
authors.initials: SG
authors.lastname: Severtson
authors.forename: Becki
authors.initials: B
authors.lastname: Bucher-Bartelson
authors.forename: Jody L
authors.initials: JL
authors.lastname: Green
mesh_terms: D000701:Analgesics, Opioid / Q000627:therapeutic use; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004363:Drug Utilization / Q000639:trends; D004335:Drug and Narcotic Control / Q000331:legislation & jurisprudence*; D006556:Heroin Dependence / Q000453:epidemiology; D006801:Humans; D009293:Opioid-Related Disorders / Q000453:epidemiology* / Q000401:mortality; D010098:Oxycodone / Q000627:therapeutic use; D064226:Prescription Drug Diversion / Q000639:trends*; D011358:Product Surveillance, Postmarketing; D014481:United States / Q000453:epidemiology
chemical_list: D000701:Analgesics, Opioid; D010098:Oxycodone