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June 20, 2016

Top 20 Abused Prescription Drugs

Opioid Epidemic Is Not the Only Factor in Record Number of Overdose Deaths

Top 20 Abused Prescription Drugs

2014 set a record for number of deaths from drug overdoses—47,055, to be exact—while nearly half a million people died from drug overdoses between 2000 and 2014. [© lacamerachiara/Fotolia]

  • The CDC delivered some scary news a few months back, reporting that 2014 set a record for number of deaths from drug overdoses—47,055, to be exact. Between 2000 and 2014, nearly half a million people have died from drug overdoses; since 2000, the rate of deaths from drug overdoses has more than doubled, increasing 137%.

    More than six out of 10 overdose deaths involved an opioid, a statistic that has further fueled growing attention by law enforcement agencies, elected officials, and others to the urgency of stopping drug abuse. In March, Massachusetts enacted the first law in the nation to impose a 7-day supply limit for first-time adult prescriptions and every opiate prescription for minors, with exceptions. Massachusetts Gov. Charlie Baker and New Hampshire Gov. Maggie Hassan said on June 9 they will urge other state governors to adopt similar laws.

    But opioids aren’t the only prescription drugs that get abused. The National Institute on Drug Abuse also includes sedatives and stimulants among its commonly abused prescription drugs.

    Listed below are the top 20 abused prescription drugs ranked by 2015 sales as furnished either by marketers of the drug or by Evaluate, the service that tracks industry sales figures. Some drugs appearing on the list are brand-name treatments, whereas others are drugs sold under numerous branded and generic versions. Each drug is listed with its 2015 sales, its Drug Enforcement Administration (DEA) drug classification status, and its indications.

    One observation of interest is that a growing number of generics have crowded out drugs that were on lists GEN published in previous years, most recently in 2014. Drugs in this category would include the brand-name treatment Xanax (alprazolam), which made GEN's 2014 List, as well as the 2013 List and the 2012 List—but which just missed this year’s List by ranking #21.

    Also, several branded drugs that made this year’s list saw their sales erode in 2015 compared with 2014, including Celebrex (celecoxib) and Zoloft (sertraline hydrochloride).

  • #20. Morphine sulfate

    Includes morphine sulfate oral (Mallinckrodt), Morphine QD (Allergan), Avinza (Pfizer), morphine sulfate (Pfizer and its Hospira subsidiary), morphine sulfate ER (Endo International), MS Contin (Purdue Pharma and Shionogi), Statex (Endo International and Paladin Labs), morfin bioglan (Meda), and morphine sulfate I.V. (Allergan)

    2015 sales: $259 million, according to Evaluate

    DEA drug classification: Schedule II

    Indications: Opioid agonist indicated for the management of pain not responsive to nonnarcotic analgesics.

  • #19. Subsys (fentanyl sublingual spray)

    Brand-name drug marketed by Jansen Pharmaceuticals (Johnson & Johnson)

    2015 sales: $334 million, according to Evaluate

    DEA drug classification: Schedule II

    Indications: Drug-in-adhesive matrix designed formulation indicated for management of pain in opioid-tolerant patients, severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate.

  • #18. Duragesic (fentanyl transdermal system) for transdermal administration, CII

    Brand-name drug marketed by Jansen Pharmaceuticals (Johnson & Johnson)

    2015 sales: $334 million, according to Evaluate

    DEA drug classification: Schedule II

    Indications: Drug-in-adhesive matrix designed formulation indicated for management of pain in opioid-tolerant patients, severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate.

  • #17. Ambien® (also sold as Myslee® and Stilnox®; zolpidem tartrate)

    Brand-name drug marketed by Sanofi; includes Ambien CR® (zolpidem tartrate extended-release tablets)

    2015 sales: €306 million ($346 million), according to Sanofi

    DEA drug classification: Schedule IV

    Indications: Gamma-aminobutyric acid (GABA) A agonist indicated for the short-term treatment of insomnia characterized by difficulties with sleep initiation. Ambien CR is indicated for treatment of insomnia characterized by difficulties with sleep onset and/or sleep maintenance.

  • #16. Adderall XR® (amphetamine/dextroamphetamine)

    Brand-name drug marketed by Shire

    2015 sales: $362.8 million, according to Shire

    DEA drug classification: Schedule II

    Indication: Central nervous system (CNS) stimulant indicated for the treatment of attention-deficit hyperactivity disorder (ADHD).

  • #15. Ritalin®/Focalin (methylphenidate HCl)

    Brand-name drug marketed by Novartis; includes Ritalin-SR® sustained-release tablets and Ritalin LA® extended-release capsules

    2015 sales: $365 million, according to Novartis

    DEA drug classification: Schedule II

    Indication: Mild CNS stimulant indicated for attention-deficit disorders. Indicated as an integral part of a total treatment program that typically includes other remedial measures (psychological, educational, social) for a stabilizing effect in children with a behavioral syndrome characterized by the following group of developmentally inappropriate symptoms—moderate-to-severe distractibility, short attention span, hyperactivity, emotional lability, and impulsivity.

  • #14. Hydromorphone HCl

    Includes Exalgo (Johnson & Johnson and Mallinckrodt), as well as hydromorphone hydrochloride ER (Allergan) and hydromorphone hydrochloride (Pfizer and its Hospira subsidiary, Mallinckrodt, Perrigo, and Akorn); does not include Dilaudid (Purdue Pharma)

    2015 sales: $368 million, according to Evaluate

    DEA drug classification: Schedule II

    Indications: Pure opioid agonist indicated for the management of pain in patients where an opioid analgesic is appropriate.

  • #13. Zoloft (sertraline HCl)

    Brand-name drug marketed by Pfizer

    2015 sales: $374 million, according to Pfizer

    DEA drug classification: Not scheduled

    Indications: Selective serotonin reuptake inhibitor indicated for major depressive disorder in adults.

  • #12. Sertraline HCL

    Includes Zoloft (Pfizer), which is listed separately, as well as Sertraline (Lupin and Teva Pharmaceutical Industries) and Stimuloton (Servier and Egis Pharmaceuticals)

    2015 sales: $417 million, according to Evaluate

    DEA drug classification: Not scheduled

    Indications: Selective serotonin reuptake inhibitor (SSRI) indicated for the treatment of major depressive disorder in adults.

  • #11. Celecox (celecoxib)

    Brand-name drug marketed in Japan by Astellas Pharma

    2015 sales: $433.5 million, according to Astellas Pharma

    DEA drug classification: Not scheduled

    Indications: Nonsteroidal anti-inflammatory drug indicated for the treatment of rheumatoid arthritis, osteoarthritis, low back pain, periarthritis scapulohumeralis, and neck, shoulder, and arm syndrome or tendonitis/tenosynovitis with anti-inflammatory/analgesic effects. It is also used to reduce inflammation and pain after operation, traumatic injuries, or tooth removal.

  • #10. Zolpidem tartrate

    Includes Ambien (Sanofi), which is listed separately, as well as Myslee (Astellas Pharma), Zolpidem (Par Pharmaceutical), Sublinox (Valeant Pharmaceuticals International), and zolpidiem tartrade ER (Par Pharmaceutical and Endo International)

    2015 sales: $558 million, according to Evaluate

    DEA drug classification: Schedule IV

    Indications: GABA A agonist indicated for the short-term treatment of insomnia characterized by difficulties with sleep initiation 

  • #9. Methylphenidate ER (LA)

    Authorized generic version marketed by Allergan

    2015 sales: $665 million, according to Evaluate

    DEA drug classification: Schedule II

    Indications: CNS stimulant used for the treatment of ADHD.

  • #8. Fentanyl

    Includes Duragesic, which is listed separately, as well as Fentanyl Transdermal System (Mylan and Allergan), Fentanyl Transdermal System Patch (Mallinckrodt), and Fentanyl Patch (STADA Arzneimittel)

    2015 sales: $719 million, according to Evaluate

    DEA drug classification: Schedule II

    Indications: Fentanyl transdermal patches are indicated for management of persistent, moderate-to-severe chronic pain that requires continuous, around-the-clock opioid administration for an extended period of time and cannot be managed by other means, such as nonsteroidal analgesics, opioid combination products, or immediate-release opioids. 

  • #7. Suboxone® (buprenorphine and naloxone) sublingual film, for sublingual or buccal use

    Brand-name drug marketed by Indivior

    2015 sales: $808 million, according to Evaluate

    DEA drug classification: Schedule III

    Indications: Partial-opioid agonist indicated as maintenance treatment of opioid dependence that should be used as part of a complete treatment plan to include counseling and psychosocial support.

  • #6. Concerta (methylphenidate HCl)

    Brand-name drug marketed by Janssen Pharmaceuticals (Johnson & Johnson)

    2015 sales: $821 million, according to Johnson & Johnson

    DEA drug classification: Schedule II

    Indications: CNS stimulant indicated for the treatment of ADHD in children 6 years of age and older, adolescents, and adults up to the age of 65.

  • #5. Celebrex (celecoxib capsule)

    Brand-name drug marketed by Pfizer

    2015 sales: $830 million, according to Pfizer

    DEA drug classification: Not scheduled

    Indications: Nonsteroidal anti-inflammatory drug indicated for osteoarthritis, rheumatoid arthritis, juvenile rheumatoid arthritis in patients 2 years and older, ankylosing spondylitis, acute pain in adults, and primary dysmenorrhea.

  • #4. Buprenorphine and naloxone

    Includes Suboxone film (Indivior), which is listed separately, as well as Zubsolv (Orexo), buprenorphine/naloxone (Allergan), and Bunavail (BioDelivery sciences International)

    2015 sales: $892 million, according to Evaluate

    DEA drug classification: Schedule III

    Indications: Buprenorphine is an opioid partial agonist; naloxone is an opioid antagonist. Combination is indicated for the maintenance treatment of opioid dependence and should be used as part of a complete treatment plan to include counseling and psychosocial support.

  • #3. Celecoxib

    Includes Celebrex (Pfizer), which is also listed separately, as well as Celecox (Astellas Pharma) and celecoxib (Teva Pharmaceutical Industries, Mylan, and Allergan)

    2015 sales: $1.428 billion, according to Evaluate

    DEA drug classification: Not scheduled

    Indication: Nonsteroidal anti-inflammatory drug indicated for osteoarthritis, rheumatoid arthritis, juvenile rheumatoid arthritis in patients 2 years and older, ankylosing spondylitis, acute pain in adults, and primary dysmenorrhea.

  • #2. OxyContin (oxycodone HCl controlled-release)

    Brand-name drug marketed by Purdue Pharma

    2015 sales: $1.5 billion, according to Evaluate

    DEA drug classification: Schedule II

    Indication: Indicated for treating moderate to severe pain in patients who require around-the-clock opioids for an extended time.

  • #1. Methylphenidate HCl

    Includes Concerta (Janssen Pharmaceuticals) and Ritalin/Focalin (Novartis), which are also listed separately, as well as methylphenidate ER (Allergan and Mallinckrodt), Metadate CD/Equasym XL (UCB), Daytrana (Hisamitsu Pharmaceutical), Quillivant XR (Pfizer), Equasym XL (Shire), and methylphenidate hydrochloride (Allergan and IMPAX Laboratories)

    2015 sales: $2.232 billion, according to Evaluate

    DEA drug classification: Schedule II

    Indication: Used almost exclusively for the treatment for ADHD in children. Can be used legitimately in the treatment of excessive daytime sleepiness associated with narcolepsy.

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