What the Doctor Ordered? Cracking Down on Prescription Drug Abuse

 Prescription drug abuse is a growing area of concern in numerous communities around the United States. The rapidly increasing negative social consequences – from higher health care costs to lost work productivity (Read The Cost of Abuse and Addiction) – have made the federal government again take notice of the epidemic and look for additional ways to curb it. This article will describe the extent and scope of the problem and what is being done to combat it.

How many Americans abuse prescription drugs?

ABC News reported that more than 27,000 people died as the result of accidental prescription drug overdoses in 2007 (Read Overdose: Why It Happens & What to Do When It Does and Emergency Visits for Substance-Related Medical Problems). Although this statistic is not restricted to prescription drug abusers, the director of the Office of National Drug Control Policy, Gil Kerlikowske, indicated that abusers did represent a significant proportion of these deaths, which signifies a substantial social problem.  As part of the Substance Abuse and Mental Health Services Administration’s (SAMHSA) 2008 National Survey on Drug Use and Health, 6.2 million Americans over the age of 12 reported using a prescription medication for non-medical (e.g., recreational) purposes during the previous month. Likewise, 52 million reported having done so at any point in their lives. Among teenagers, the problem is particularly concerning because some reports indicate that they will experiment with “highs” by mixing unknown substances at “pharm parties” using drugs that they have obtained from friends and relatives. In addition to the possibility of developing addictions, the potential for negative drug interactions leading to serious consequences or even death are alarming for parents, educators, and policymakers.

How has prescription drug abuse become such a serious problem?

A phenomenon that touches everyone from teenagers to seniors to celebrities, abuse of prescription medications is partly the result of their accessibility (Read Substance Abuse and Seniors and Michael Jackson & Dangers of Prescription Drug Abuse). Although a doctor’s prescription is necessary to obtain them from a pharmacy, they may easily be found in many home medicine cabinets and, for this reason, are arguably not much more difficult to procure than legal substances like alcohol and tobacco (Read Parents & Pills: Unintentional Drug Dealers) – and, if stolen, are cheaper.  Additionally, prescription drugs seem to have less of a social stigma associated with their use compared to that which accompanies use of illegal drugs like marijuana, heroin, cocaine, and crack. Despite federal regulation of these drugs (Read Drug Scheduling and the DEA), persistent patients who feign the severity of pain or other relevant symptoms can persuade even a hesitant doctor to write the scrip that they are looking for (Read Opiophobia: Addiction and Pain Management).

What are some prescription medicines that are frequently abused?

Among the medications that are often abused are: opiates (e.g., Oxycontin, Vicodin), benzodiazepines (e.g., Xanax, Klonopin), amphetamines (e.g., Adderall), barbiturates (sedatives), stimulants (e.g., Ritalin), and tranquilizers.  Although any of these drugs may be abused by patients and others, much of the problem centers around the abuse of opiates.

What is the government doing to decrease this problem?

In addition to simply raising awareness through research and creative outlets (Read NIDA’s Addiction Performance Project and NIH & the GRAMMY Foundation Team up against Teen Substance Abuse), the government has historically regulated the manufacture, transportation, and distribution of medications through agencies like the DEA and the Food and Drug Administration. SAMHSA represents another federal attempt to help those with alcoholism and addiction (Read SAMHSA: Government Resources for Addiction at samhsa.gov). Most recently, in April 2011, the government proposed requirements for a Risk Evaluation and Management Strategy (REMS) that will involve drug manufacturers and will require more extensive physician education about prescribing addictive substances. Manufacturers of prescription medicines have been given 120 days to develop a REMS proposal. As part of this plan, state monitoring programs will be increased, more support will be given to patient and physician education, citizens will be encouraged to dispose of old medications, and law enforcement related to abusive behaviors will be increased.

How can I tell if someone I know is abusing or addicted to prescription drugs?

Although the physical symptoms of prescription drug abuse vary by substance, many of the behaviors that are often indicative of a problem with prescription meds are similar (Read Prescription Drug Abuse: When to Be Concerned and 3 Signs of Opiate Abuse).  If the person increases the frequency of consumption, raises the dose, or extends the “treatment period” without a doctor’s permission, these are considered abusive behaviors even if the person justifies it to themselves and others as “necessary because of pain” or other reasons.  Changing the method of administration (Read Method of Administration: Why “How” Matters) is also a red flag.  Someone who is abusing one or more of these drugs may try to stock pile them because they are afraid of running out and experiencing withdrawal (Withdrawal and Detox: Get the Facts). They may be “playing” multiple doctors for additional prescriptions; they may also steal or engage in other illegal and risky behaviors to obtain the drug.

What can I do if I have unused or expired medications in my home?

In April 2011, the DEA held a drug take-back day and allowed individuals to return unused medications across the country without being asked any questions about how they were obtained or what they were used for.  The first such day occurred in September 2010 and resulted in the collection of nearly 250,000 pounds of drugs.  As part of 2010 legislation called the Secure and Responsible Drug Disposal Act, permanent drop-off locations will be established in numerous neighborhoods around the United States. Until this network has been developed, you can check for future drop off dates on the DEA’s website.  Otherwise, you can also dispose of these drugs by removing them from their labeled containers and mixing them with a substance that would discourage someone from removing it from the trash and using it – such as compost, coffee grounds, or cat litter.