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The New War on Drugs: Prescription Meds

Submitted by Stephanie Andre on October 11, 2013 – 2:50 pm

Drug abuse now kills more Americans per year than homicide or car accidents and is now the fastest-growing cause of accidental death in the U.S., according to recent studies. But the term “drug abuse” is broad. If you delve a bit deeper, you’ll see that much of this war is now fought on different turfs: the doctor’s office, your local pharmacy and even college campuses, where the use of prescription pills is rampant—whether it’s to help cram for exams or to earn extra cash.

According to the U.S. Centers for Disease Control and Prevention (CDC), one person dies from a drug overdose every 19 minutes. In fact, exactly 28,754 Americans died after accidentally overdosing on legal or illegal drugs in 2009—and approx. half of those deaths involved prescription painkillers. What’s more, for every person who dies from prescription meds, there are 32 more emergency room visits. The numbers are so grim that some experts have now declared prescription drug abuse an epidemic.

The soaring increase in sales of prescription painkillers explains most of the deaths. In 1999, a total of 2 kg of such drugs were sold for every 10,000 people; as of 2010, that number had jumped to about 7 kg. According to the CDC, opioid analgesics, such as methadone, hydrocodone and oxycodone are the most common cause of drug poisoning.

Fighting the Battle from Behind
While the abuse of prescription medications is nothing new, the growth with which it has increased is staggering. Part of the blame goes to society’s other “War on Drugs”—particularly marijuana. With the vast efforts to curtail decades of fight on legalizing the drug, lawmakers and other influencers have neglected what’s right in front of them.

Now, as doctors, decision makers and society attempt to play catch-up, the problem has already gone global, making it more than simple to acquire prescription pills if you should so desire.

More people now die from analgesic pain relievers, such as OxyContin and Vicodin, than cocaine and heroin combined, yet prescription-pill abuse still only receives a fraction of the resources invested in criminal justice and law enforcement against illegal drugs. That said, in an attempt to begin to curtail the bleeding, the Food and Drug Administration in September announced that it will require starker warning labels on OxyContin and certain other narcotic painkillers as part of an effort to combat the rampant addiction and misuse that lead to thousands of deaths each year.

The labeling changes will apply to all extended-release and long-acting opioid painkillers. The most widely used of those includes oxycodone, which can be found in Oxy- Contin and similar drugs.

“FDA is extremely concerned about the inappropriate use of opioids, which has reached epidemic proportions in the United States and has become a major public health challenge,” says FDA commissioner Margaret A. Hamburg, M.D.

Despite this recent news, some institutions are taking it upon themselves to put measures in place to place a tighter rein on those who actually have prescriptions.

Why the Uptick?
So why is prescription med use on the continued rise? Well, for starters, these drugs are easy to get. Just ask anyone who’s ever suffered an injury or an ADHD patient.

According to the CDC, almost all prescription drugs are obtained legally, rather than from pharmacy theft, for example, though thefts are growing. In most situations, the drugs come from friends and relatives for whom the prescriptions were originally written.

The prescriptions originate from a tiny number of medical professionals who work in primary care, internal medicine and dentistry—not specialists. About 20% of prescribers write 80% of painkiller prescriptions, according to recent studies.

The New Battle Field: College
While illegal drugs traditionally invoke images of back alley transactions and seedy spots, prescription drug abuse is more mainstream. Specifically, college students have taken a liking to the meds, using them to pull all-nighters and cram for exams. And don’t forget the other side of the equation: earning extra cash for the sellers as well. After all, what college student doesn’t need money?

While alcohol abuse and binge drinking still top the list of substance abuse issues on college campuses, the nonmedical use of prescription drugs—most notably stimulants, sedatives and pain relievers—is a growing, yet unaddressed problem, according to the Substance Abuse and Mental Health Services Administration (SAMSHA). In fact, about one in four college students has illegally used prescription drugs, and many more have been offered these medications by friends or fellow students.

In fact, among people 18 to 22, full-time college students are twice as likely to use a stimulant for nonmedical reasons in the past year compared to those who aren’t in college or are only part-time students, according to a 2009 SAMSHA study.

By students’ sophomore year in college, about half of their classmates will have been offered the opportunity to abuse a prescription drug, says a 2008 study published in Substance Abuse.

What’s more, college students who used Adderall were almost three times as likely as those who had not used Adderall nonmedically to have used marijuana in the past year, eight times more likely to have used cocaine or be nonmedical users of prescription tranquilizers and five times more likely to have been nonmedical users of prescription pain relievers, according to SAMHSA.

Similar studies suggest more of the same. In surveys, college students who took an opioid for reasons other than for pain relief (for example, getting high or experimenting) had a much greater risk of experiencing three or more drug-use related problems, says Sean McCabe, Ph.D., University of Michigan Substance Abuse Research Center & Institute for Research on Women and Gender. His research shows that students who take prescription drugs for nonmedical reasons are at least five times more likely to develop a drug abuse problem than those who don’t.

Makes you ‘Smarter?’
The major difference between those in college who abuse prescription meds and those who smoke marijuana is that these kids don’t start off taking the pills for the thrill of getting high. They do it to stay up later; to get better grades. They want to be “smarter” and figure that getting a quick “pick me up” isn’t such a bad thing.

“When I’m on Adderall and I’m looking at the textbook I can forget about everything else around me,” a top student at one of the nation’s top tier colleges told NBC News’ Amy Robach, in a report that aired on “Today” in 2011. “I figured if everyone else is doing it, why shouldn’t I get the advantage?”

It’s All Business, After All
For more than two decades, college students have illegally taken prescription stimulants to stay awake and hyperfocused while studying. As sales of medications for ailments, such as ADHD (Attention Deficit Hyperactivity Disorder) increase, so does the demand for grade-conscious college kids looking for some “help” to get them through all-night study sessions.

Gone are the days of study aids such as Mountain Dew and coffee. Today’s college students need “more”—and that’s where their classmates come in. The story usually goes like this: Average college student on a need-based, doctor-sanctioned medication misses a pill here or there. In turn, she has pills left over so she “shares” them with friends for $5 or $10 each.

While most schools have no-tolerance policies for the sale of any drug, moving prescription pills seems to be something the institutions haven’t quite gotten a good hold on yet. Students who abuse study drugs don’t smell of marijuana or show the the average signs of binge drinking.

Study drugs are “kind of a silent issue. Everyone’s aware of it, but I think we’re all focused on the more prevalent one—alcohol,” Daniel Swinton, president of the Association for Student Conduct Administration and an assistant dean at Vanderbilt University, told The Washington Post.

Another major problem for the universities: you can find pills at just about any time. In a “Today” show hidden camera investigation, the program sent an intern into a library at a top college. In less than one minute, the intern asked a student he didn’t even know if he knew anyone that could get him some Adderall. The student replied, ”Yeah, me.”

The Doctor’s Role
Some argue that prescription-happy doctors are just as much to blame as anyone else. College students say that the only thing easier than buying meds such as Adderall on campus is Googling “ADHD symptoms” and hitting up your local doctor. Chances are, you’ll walk out of your appointment with a legal prescription for the drug.

Whether it’s a lack of moral character or pressure from Big Pharm, some doctors seem to have little trouble—or conscience—in doling out prescriptions. Too lenient and too easy with their prescription pad, doctors fail to take the time to inspect the real severity of a patient.

More often than not, doctors take the client’s word for granted and trust their articulated symptoms without seeing any real evidence toward ADHD, for example.

Hope for the Future
So where do we go from here? The abuse of prescription pills for any reason whatsoever is only getting worse. The “War on Drugs” continues and as the money machine continues to rule the world so will the laws of supply and demand.

Education is key and the choices we make are vital. If you have children, take the time to talk with them about the dangers of all drugs. Remember, under the proper guidance of a board-certified physician, the use of prescription pills can, in fact, increase one’s quality of life. But, be smart. Know the facts. After all, if abused, the use of prescription pills will become an addiction.

“There’s such a low perception of risk involved with these drugs,” says Steve Pasierb, president and CEO, Drugfree.org. “People think because they’re FDA approved, that they aren’t dangerous or addictive, and that increases the likelihood of use.”

Adds Hamburg: “We must recognize the medical value [painkillers] have for many patients living with pain. Therefore, the [FDA] must strike a balance between their benefit in treating patients with pain and the risks associated with misuse, abuse, addiction, overdose and death.”