A majority of test results from patients taking prescription medications show signs of drug misuse, including potentially dangerous drug combinations, according to a new large-scale analysis of laboratory test results from Quest Diagnostics, Madison, NJ.1

The Quest Diagnostics study is based on analysis of the company’s deidentified laboratory data, believed to be one of the largest nationally representative datasets of objective laboratory information from patients prescribed opioids and other commonly abused medications.

The study examined 3.4 million prescription medication monitoring lab tests performed by Quest Diagnostics between 2011 and 2016. Results showed that while evidence of misuse has declined in recent years, 52% of test results showed evidence of potential misuse in 2016, suggesting a majority of patients took their prescribed drugs in ways that were inconsistent with their physicians’ instructions. By comparison, in 2011, 63% of test results were inconsistent with a physician’s orders.

Quest Diagnostics lab crop640“Over the past several years, federal and state government, clinician organizations, public health advocates, and providers have all launched campaigns to educate the public about the perils of prescription drug misuse, which hypothetically should have yielded a significant rate of improvement,” says lead author F. Leland McClure, PhD, MSci, F-ABFT, medical science liaison director at Quest Diagnostics. “Yet our study shows that every other American tested for possible inappropriate use of opioids and other prescription drugs is potentially at risk. This finding is rather shocking, and speaks to the challenges of combating the nation’s drug misuse epidemic.”

The study also found disturbing patterns of concurrent drug use.

Among more than 33,000 specimens tested for opioids, benzodiazepines, and alcohol in 2016, more than 20% were positive for both opioids and benzodiazepines, more than 10% were positive for both opioids and alcohol, and 3% were positive for all three.

The study also found that one in five (19%) specimens positive for heroin in 2016 was also positive for nonprescribed fentanyl. Fentanyl is 50 to 100 times more powerful than morphine. When combined with heroin, fentanyl heightens the risk of drug overdose death.

“Accidental drug overdose is a serious problem in the United States,” says Jeffrey Gudin, MD, medical advisor at Quest Diagnostics and director of pain management and palliative care at Englewood Hospital and Medical Center. “It appears from our analysis that many patients may be at risk of overdose or other adverse health effects caused by concurrent use of opioids, including fentanyl and other drugs such as benzodiazepines.”

Quest researchers found drug misuse rates were high among most age groups and both genders. However, adolescents (10–17 years of age) showed a striking improvement, with the inconsistency rate dropping from 70% to 29% between 2011 and 2016.

Misuse rates were higher for men and women of reproductive age (58%) than in the general study population (52%). The findings are significant because opioid and benzodiazepine use may decrease male fertility and, if taken during pregnancy, increase the risk of birth defects and other health concerns.

For more information, visit Quest Diagnostics.

REFERENCE

  1. Prescription drug misuse in America: diagnostic insights in the growing drug epidemic [online]. Madison, NJ: Quest Diagnostics, 2017. Available at: www.questpdm.com/wp-content/uploads/2017/09/questdiagnostics_pdm_healthtrends_2017.pdf. Accessed October 2, 2017.