The burden of the nonmedical use of prescription opioid analgesics.

An increase in the prescribing of opioids over the past several years often has been perceived as the primary reason for the increase in the nonmedical use of prescription opioids. Determining the prevalence of this illicit use has been difficult, because of varied methodologies and terminologies that are used to estimate the number of people directly contributing to or affected by this burden. Despite these discrepancies, the findings from several nationally recognized surveys have demonstrated that the prevalence of nonmedical prescription opioid use is indeed significant and has been increasing in recent years. The considerable burden on society imposed by misuse and abuse of these drugs is largely due to the monetary costs associated with nonmedical use (e.g., strategies implemented to prevent or deter abuse, treatment programs for misusers, etc.), decreased economic productivity, and the indirect effect on access to appropriate health care. However, using various nonpharmacologic and pharmacologic approaches to treat patients who use prescription opioids illicitly can decrease its overall prevalence and associated impact, with the development of novel opioid formulations designed to reduce nonmedical use providing valuable clinical tools as part of an overall risk management program. In addition, prescription monitoring programs are a prevalent drug control system designed to identify and address abuse and diversion of prescription medications, including opioids. Such resources, along with an accurate understanding of the problem, extend greater hope that the public health challenge of nonmedical prescription opioid use can be effectively mitigated.