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Prescription drug abuse now an epidemic in U.S. 

Sometimes the biggest threats at first glance seem quite innocuous. In reality, however, we do not need to look at our borders, inner cities or rural backwaters for the biggest drug threats to our nation, but rather in our medicine cabinets.

Prescription drug abuse graphic

The Centers for Disease Control and Prevention has classified prescription drug abuse as an epidemic.  There is a tendency, particularly among younger people, to believe that prescription drugs are safer than illicit drugs because they are legal and pass through the hands of a pharmacist. Perhaps this is why the threat has grown quietly, but lethally. In fact, drug overdose deaths, due mostly to the misuse or abuse of prescription drugs, are now reported to the leading cause of accidental death in the United States.  

A 2005 report by the National Center on Addiction and Substance Abuse at Columbia University suggests between 1992 and 2003, more Americans were abusing controlled prescription drugs than cocaine, hallucinogens, inhalants and heroin put together. According to the study, the number of Americans who admit abusing prescription drugs almost doubled to over 15 million from 1992 to 2003, with abuse among teenage figures tripling. The trend has continued to worsen.

The White House’s Office of National Drug Control Policy (ONDCP) lays out the chilling facts: “Prescription drug abuse is the Nation’s fastest-growing drug problem. While there has been a marked decrease in the use of some illegal drugs like cocaine, data from the National Survey on Drug Use and Health (NSDUH) show that nearly one-third of people aged 12 and over who used drugs for the first time in 2009 began by using a prescription drug non-medically.”

The same survey found that over 70 percent of people who abused prescription pain relievers got them from friends or relatives, while approximately 5 percent got them from a drug dealer or from the Internet.  Additionally, the latest Monitoring the Future study—the Nation’s largest survey of drug use among young people—showed that prescription drugs are the second most-abused category of drugs after marijuana (see p. 57, Table 5).  In our military, illicit drug use increased from 5 percent to 12 percent among active duty service members over a three-year period from 2005 to 2008, primarily attributed to prescription drug abuse.

Clearly, this is a serious and growing problem, made worse by the ease of access. One way of helping to keep youth from abusing prescription drugs in the home is to better limit their access. If it is necessary to keep medicines in the home, they should be under lock and key. While there is no one device recommended for safeguarding medications, there are several lock boxes and portable safes on the market. An existing fire safe or gun safe also works.

The most commonly misused prescription drugs fall into three classes. Opioids, including OxyContin and Vicodin, as well as the generic oxycodone and hydrocodone, are from the same family of drugs as heroin. They are commonly prescribed for post-operative pain and to alleviate the severe, chronic pain of terminal conditions such as cancer, and degenerative conditions like rheumatoid arthritis. Used for a ‘high’, they become powerfully addictive drugs that users need more and more of to get high and can lead to the behavior of a heroin addict, with the user doing anything to get their next pill. Few primary care physicians pay adequate attention to patients taking prescription opioid drugs despite the potential for abuse, addiction and overdose, according to a new study by researchers at Albert Einstein College of Medicine of Yeshiva University. The study, published in the March 2, 2011 online edition of the Journal of General Internal Medicine, found lax monitoring even of patients at high risk for opioid misuse, such as those with a history of drug abuse or dependence.
  
The second category is central nervous system depressants, which include benzodiazepines (Valium, Klonopin, Xanax, etc.), barbiturates (phenobarbital, Mebaral, Fiorinal, etc.) and sedatives/hypnotics (Halcion, Ambien, ProSom, etc.). Prescribed to millions of people with anxiety disorders and for short-term use by insomniacs, they also are sought to achieve a calming ‘high’.
 
Lastly, Ritalin, Dexedrine and other stimulants help children with attention deficit disorder, and people with asthma or narcolepsy. Abuse occurs by taking in large doses or crushing the pills, which produces a similar high — and cause the same harm — as methamphetamine and other illegal drugs. In addition to becoming addictive, they can make the heart beat erratically, drive body temperatures dangerously high, or even cause lethal seizures.
 

In 2011, the ONDCP released the prescription drug abuse prevention plan, Epidemic: Responding to America’s Prescription Drug Abuse Crisis, which outlines action in four major areas to reduce prescription drug abuse:

1. Education. A critical first step in tackling the problem is to educate parents, youth, and patients about the dangers of abusing prescription drugs while requiring prescribers to receive training in the safe and appropriate use of these drugs. (Among those who said they obtained the pain reliever from a friend or relative for free, 80 percent reported that the friend or relative had obtained the drugs from just one doctor. Source: 2009 National Survey on Drug Use and Health (NSDUH): National Findings, SAMHSA (2010))

2.  Monitoring. Implement prescription drug monitoring programs (PDMPs) in every state and enhance PDMPs to make sure they can share data across states and are used by healthcare providers. The Washington State Department of Health recently established several prevention initiatives including a Prescription Monitoring Program. The program collects information on the purchases of pain medications and other potentially dangerous medicines from pharmacies and health care providers. The information is used to help reduce abuse and promote patient safety. Hydrocodone/Acetaminophen (the generic form of Vicodin, a pain reliever) makes up roughly 25 percent of all the prescriptions collected. (Source: Chris Baumgartner.)

3. Proper Medication Disposal. Develop convenient and environmentally responsible prescription drug disposal programs to help reduce prescription drug diversion.

4. Enforcement. Provide law enforcement with the tools necessary to eliminate improper prescribing practices and reduce “pill mills” and “doctor shopping.”

Commonly Abused Prescription Medications

 

Hydrocodone/Acetaminophen

(Vicodin)

This opiod is commonly referred to by the name of Vicodin. The drug is a powerful painkiller with a high potential for addiction and can cause side effects. Vicodin has become a popular drug for abuse and when taken with alcohol is extremely damaging and dangerous.

Oxycodone/Acetaminophen (Percocet)

Oxycodone is commonly known as Percocet. The drug is an opioid and pain reliever with severe addictive affects and a high potential for abuse. However, medical detox from Percocet with the use of buprenorphine is a safe process that can usually be completed in six to eight days. Several websites provide excellent resources for ending Percocet abuse.

Zolpidem (Ambien)

Ambien is a popular sleep aid that is also abused for its sedative, hallucinogenic and euphoric effects. The drug is available in pill form and is often crushed in order to be snorted or injected. Withdrawal can be painful ranging from muscle cramps and sweats to shaking and seizures.

Alprazolam (Xanax)

Alprazolam is a commonly abused prescription drug referred to as Xanax. Xanax is a depressant that is also sometimes referred to as a tranquilizer and is supposed to be used to treat such thing as anxiety and panic attacks. However it is highly addictive and often abused in addition to other drugs creating huge dangers to the individual. Xanax is part of a growing number of prescription drugs flooding the streets.

Lorazepam (Ativan)

Lorazepam is an addictive drug used for treating anxiety from the same family as diazepam (Valium), alprazolam (Xanax) and others. Lorazepam reduces the activity of nerves in the brain and often produces drowsiness, dizziness or sedation. Commonly referred to as Ativan, the drug is highly addictive and those who are using Ativan without having it prescribed by their doctor.

Clonazepam (Klonopin)

Clonazepam, commonly marketed as Klonopin is the name for a group of anti-anxiety medications with a dangerously slow onset that takes up to four hours to peak.

Amphetamine

Amphetamine is part of a class of drugs that are powerful stimulants affecting the central nervous system. Amphetamines are stimulants and included in such brand name drugs as Adderall while also being closely related to dangerous drugs such as methamphetamine.

Methylphenidate

Commonly referred to as Ritalin, methylphenidate is a psycho-stimulant drug used for the treatment of ADD and ADHD. When abused, Ritalin can be taken orally as intended or smoked, snorted or even injected. While not as strong as amphetamines, Ritalin is stronger than caffeine and commonly abused for the energy and clarity some people get from it.

Morphine

Morphine is an extremely powerful pain reliever from the opiate family. Morphine is used in a hospital setting and is highly addictive with severe side effects including asphyxiation due to trouble breathing. Morphine addiction is difficult and withdrawal is not easy.

Tramadol

Tramadol is considered a non-controlled pain reliever marketed as Ultram or Ultracet. The substance has been found to be addicting yet is not controlled by the DEA though several states have listed Tramadol as a controlled substance under state laws. Tramadol has created issues by rapidly increasing intoxication levels leading to deaths due to driving under the influence and impairment.