The idea that abuse of prescription drugs isrampant is no longer a subject of debate, but rather one offact.

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Add to that fact that another serious problem with patientsprescribed opioids is that they now take them in combination withother drugs that don’t mix well with the powerful painkillers.

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A study by Madison, New Jersey-based QuestDiagnostics, the lab data company, found that more than half ofthose who take opioid medications do so in“ways that put their health at risk,” either because they showedevidence of an unsafe combination of drugs or they showed that thepatient was skipping doses.

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Fifty-four percent of the more than 3.1 millionphysician-ordered tests that the firm analyzed from 2015 showedevidence of misuse.

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And yet, there’s good news. The multiyear analysis found thattest results from 2011 showed a misuse rate of 64 percent. Sothings are apparently getting better.

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Except they’re not getting better in every regard. Amongpatients flagged as misusers, the percentage that were taking drugsthat had not been prescribed by doctors had increased, from 32percent in 2011 to 45 percent in 2015. Interestingly, thepercentage only really jumped last year — it had only slightlyincreased in the four preceding years.

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One of the most common issues is people who are prescribedopioids and continue to take sedatives. Mixing the two can producepotentially fatal complications.

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Health and treatment advocates have been pleading with thegovernment and the medical community in recent years to take bigsteps, in terms of regulation and culture, to prevent abuse andmisuse of opioids. In addition to urging physicians to morecarefully scrutinize requests for opioid prescriptions, advocateshave said that medical professionals must more carefully educatepatients on how to take the medications safely.

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Doctors have clearly responded. Opioid prescriptions have fallenin each of the last three years after steadily rising for twodecades. Medical authorities, such as the Centers for DiseaseControl, have recommended a narrower set of conditions for whichopioids can be prescribed, and they have also cautioned doctors toconsider the risks of abuse and addiction when deciding whether toissue a prescription or — perhaps more importantly — when decidingwhether to renew one.

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“The culture is changing,” Dr. Bruce Psaty, a drug safetyresearcher at the University of Washington in Seattle, toldThe New York Times in May.

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Dr. Harvey W. Kaufman, a co-author of the Quest study, said in astatement accompanying the report that improvements were coming,but not fast enough.

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"The CDC's recent recommendations to physicians to carefullyweigh the risks and benefits of opioid drug therapy are a step inthe right direction, but clearly more needs to be done to addressthis public health crisis,” he says.

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