Report shows more Americans mixing prescription drugs

More Americans misusing their prescribed drugs are mixing them with other drugs, leading them to increased risk of overdose, according to a new report.

Quest Diagnostics, a leading provider of diagnostic information worldwide, analyzed more than 3.1 million test results from 2011 to 2015 that show 45 percent of patients misusing their prescriptions were using one or more drugs in addition to their prescription. The 2015 analysis was up 10 percentage points from the analyses done in 2013 and 2014.

"The increase in inconsistency is worrisome as our data suggests high rates of potentially dangerous drug combinations," the report reads.

Multiple drug use was the single largest contributor to unintentional drug overdoses in Ohio in 2014, the most recent statewide data available. The Ohio Department of Health reported 59 percent of overdose deaths where the number of drugs was specified involved more than one drug, which was up from 57 percent in 2013. In 2014, death certificates listed drug information for 2,257 of the 2,531 overdose deaths.

Benzodiazepines, psychoactive medications like Xanax and Valium, were present in at least 328 deaths. Quest's analysis found that 1 in 3 of patients who tested positive for heroin also was using benzodiazepines with 92 percent of them not having a prescription. Benzodiazepines can have strong sedative effects, including respiratory depression, when combined with alcohol, other sedatives and illicit drugs like heroin.

"For some patients, opioids and sedatives are co-prescribed which is of concern. The discovery that a growing percentage of people are combining drugs without their physician's knowledge is deeply troubling given the dangers. Perhaps patients do not understand that mixing even small doses of certain drugs is hazardous, or they mistakenly believe prescription medications are somehow safe," said co-researcher F. Leland McClure III, Quest Diagnostics medical affairs director and a fellow of the American Board of Forensic Toxicology.

While the percent of combining prescriptions with other drugs is on the rise according to Quest's results, the overall number of patients not following doctor's orders, which includes habits like not taking their prescribed medication, was fairly stable. Quest reported 54 percent of patient results showed evidence of misuse in 2015, up slightly from 53 percent in 2014, but down significantly from 63 percent in 2011.

In the region including Ohio, 54.5 percent of patients showed misuse, which was down from about 62 percent in 2011.

The report speculates the decreases seen since 2011 may be attributable to increased awareness among both physicians and patients about the addictive nature of opioids. In March, the CDC finalized guidelines recommending that alternatives to prescriptions are preferred for chronic pain care and physicians should consider opioid therapy only if the expected benefits outweigh anticipated risks.

"The key takeaway from this massive, nationally representative analysis is that despite some gains, a large number of patients use prescription drugs inappropriately and even dangerously," said co-researcher Harvey W. Kaufman, M.D., Quest Diagnostics senior medical director. "The CDC's recent recommendations to physicians to carefully weigh the risks and benefits of opioid drug therapy are a step in the right direction, but clearly more needs to be done to address this public health crisis."

While Quest's analysis provides a glimpse nationally of patients taking prescription medications, the study notes it is "not broadly representative of all patients taking prescription medications" since it does not provide services for all clinicians. The study also notes it's possible their results are impacted if clinicians don't report all medications a patient is prescribed and if a patient is being tested due to suspicion of misuse.

jison@Gannett.com

Twitter: @JonaIson