US retail sales of five major prescription painkillers soared 88% during 1997-2005, according to an analysis of data from the federal Drug Enforcement Administration carried out by the Association Press.

In 2005 alone, sufficient quantities of codeine, morphine, oxycodone, hydrocodone and meperidine were sold at retail to provide everyone in the nation with more than 300mg of pain relief each, it says.

The biggest increase was in sales of oxycodone products, which rose almost sixfold. The study estimates that the main reasons for the overall fast growth in these products’ use during the period were: the aging population; intensive and unprecedented marketing campaigns by manufacturers; and the medical profession’s belief in pain management as part of overcoming illness.

However, the pattern is changing. While retail sales of prescription painkillers grew 150% in 2001, by 2005 the annual increase was down to no more than 2%, and more and more doctors are becoming reluctant to prescribe strong painkillers, even for patients who desperately need them.

One reason has been the growing abuse of prescription painkillers, with related emergency room visits having gone up more than 160% since 1995, and criminal prosecution of physicians for overprescribing or otherwise illegally providing the drugs.

Manufacturers which failed to reveal the addictive nature of their products have also been targeted – Purdue Pharma, which makes the leading oxycodone product OxyContin, has pleaded guilty to misleading patients, physicians and regulators about the product’s risk of addiction, and on July 31, at a US Senate Judiciary Committee hearing on the case, Committee chairman Senator Patrick Leahy commented: “the criminal conduct involved in the marketing of OxyContin has been one of the most tragic examples in recent memory of a company favoring the bottom line over the health of our nation’s citizens.”

In Tennessee, the state which reported a 206% increase - the nation’s highest - in prescription painkiller sales during 1997-2005, another reason for the fast growth has been the generous drug benefit provided by Tenncare, the state’s Medicaid program which covers 1.2 million low-income children, pregnant women and disabled people. In June, the state moved to tackle this problem by making “doctor shopping”- the practice of obtaining multiple prescriptions for painkillers from a number of doctors – a felony for Tenncare enrollees, and it plans to widen the prohibition to all patients by next year. By Lynne Taylor