Last week pharmacy benefits manager Express Scripts released a study of 6.8 million Americans who had at least one prescription for an opioid filled between 2009 and 2013. The findings? One piece of good news and a lot of red flags related to a medication that was involved in 16,000 overdoses in 2012 alone.

• Nearly 60 % of patients taking the painkillers to treat long-term conditions were also being prescribed muscle relaxants or anti-anxiety drugs that could cause dangerous reactions.
• Nearly one-third of patients were prescribed an opioid and a muscle relaxant in the same month, and around the same percentage were prescribed a muscle relaxant and an opioid at the same time.
• About 8% of patients were taking all three types of drugs — a combination known as a “Houston cocktail,” which gives a heroinlike high — during the same period.
• 27% were taking more than one opioid at a time, another hazardous combination.
• Of the patients taking the mixtures, two-thirds were being prescribed the drugs by two or more doctors
• Nearly 40% filled their prescriptions at more than one pharmacy.
• Overall use of opioids had fallen, especially for people using them to treat short-term ailments.

“Not only are more people using these medications chronically, they are using them at higher doses than we would necessarily expect,” said Dr. Glen Stettin, a senior vice president at Express Scripts. “And they are using them in combinations for which there isn’t a lot of clinical justification.” Read more…