Half of Americans Tested Misused Prescription Medications, Lab Tests Show

Quest Analysis of 3.4 million tests shows evidence of dangerous drug combinations

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

The Quest Diagnostics Health Trends study is based on analysis of the company's de-identified laboratory data, believed to be one of the largest nationally representative datasets of objective laboratory information of patients prescribed opioids and other commonly abused medications. Physicians order laboratory services to aid their ability to monitor patients for signs of prescription or illicit drug misuse or abuse.

The report, "Prescription Drug Misuse in America: Diagnostic Insights in the Growing Drug Epidemic," was released at the medical conference PAINWeek 2017, being held September 5–9 in Las Vegas. The examination of 3.4 million prescription medication monitoring lab tests performed by Quest Diagnostics between 2011 and 2016 paints a stark picture of the continuing epidemic of prescription drug misuse, and the dangerous, potentially deadly patterns of that misuse.

The study found 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 physician's instruction. By comparison, in 2011, 63% of test results were inconsistent with a physician's orders.

"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. Yet our study shows that every other American tested for possible inappropriate use of opioids and other prescription drugs is potentially at risk," said lead author F. Leland McClure, PhD, MSci, F-ABFT, director, medical science liaison, medical affairs, Quest Diagnostics. "This finding is rather shocking, and speaks to the challenges of combating the nation's drug misuse epidemic."

The study 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. Opioids and benzodiazepines depress the central nervous system. When they are combined, respiratory suppression, cardiac distress, and death by overdose can occur.

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

Quest researchers found drug misuse rates were high among most age groups and both genders. However, adolescents (10 to 17 years of age) showed a striking improvement, with the 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%). Opioid and benzodiazepine use may decrease male fertility and, if taken during pregnancy, increase the risk of birth defects and other health concerns.

Sources: Quest Diagnostics; September 6, 2017 Quest report; September 2017.