A reassessment of trends in the medical use and abuse of opioid analgesics and implications for diversion control: 1997-2002

J Pain Symptom Manage. 2004 Aug;28(2):176-88. doi: 10.1016/j.jpainsymman.2004.01.003.


This study updates a previous analysis of trends in medical use and abuse of opioid analgesics, and provides data from 1997 through 2002. Two research questions were evaluated: 1) What are the trends in the medical use and abuse of frequently prescribed opioid analgesics used to treat severe pain, including fentanyl, hydromorphone, meperidine, morphine, and oxycodone? 2) What is the abuse trend for opioid analgesics as a class compared to trends in the abuse of other drug classes? Results demonstrated marked increases in medical use and abuse of four of the five studied opioid analgesics. In 2002, opioid analgesics accounted for 9.85% of all drug abuse, up from 5.75% in 1997. Increase in medical use of opioids is a general indicator of progress in providing pain relief. Increases in abuse of opioids is a growing public health problem and should be addressed by identifying the causes and sources of diversion, without interfering with legitimate medical practice and patient care.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Analgesics, Opioid / supply & distribution*
  • Analgesics, Opioid / therapeutic use*
  • Comorbidity
  • Drug Prescriptions / statistics & numerical data
  • Drug Utilization / trends
  • Opioid-Related Disorders / epidemiology
  • Pain / drug therapy*
  • Pain / epidemiology*
  • Patient Care Management / methods
  • Patient Care Management / statistics & numerical data*
  • Patient Care Management / trends*
  • Registries
  • Substance-Related Disorders / epidemiology*
  • United States / epidemiology


  • Analgesics, Opioid