Common sense suggests that if we flood the market with a product that has addictive qualities, the likelihood of more people suffering from dependence on those substances will increase. If we look at the statewide and national trends, including the overall distribution of prescription medication and compare that to the number of patients seeking recovery for prescription drug addiction, it would seem that basic logic should prevail. Between 1999 and 2010, the distribution of prescription opioid pain relievers throughout the nation increased dramatically.
Not without Warning
In late 2011, the Centers for Disease Control and Prevention (CDC) warned the nation that opioid pain relievers were becoming a serious health risk. An analysis done in 2010 showed that motor vehicle deaths were now fewer than drug overdose deaths. More than half of those drug related fatalities were because of prescription medication. Of that number of drug related fatalities, almost 75% of all fatal overdoses were directly related to opioid painkillers. If these statistics were related to any ‘street drug,’ is there any doubt that people would be up in arms to find the distributors and putting a stop to the supply of substances killing more Americans, than those dying in motor vehicle accidents?
Of course, the problem is not merely limited to opioid painkillers. Dangerous substances are used to ease anxiety and insomnia; a few examples include Librium, Ativan, Valium and Xanax. The statistics from the Department of Health show that these potentially addictive medications are more commonly distributed than ever before. Has the nation become far more ill all of a sudden or is there another problem below the surface?
A Common Problem
According to the Office of Alcoholism and Substance Abuse Services in New York, the office saw a 150% increase in people (age 18 to 35) who cited a prescription drug as their primary drug abuse when seeking a rehab program. For many people, the problem is availability and perception. Most people who think about experimenting realize that heroin and cocaine are dangerous; they have to go through illicit means to get access to these substances because they are not commonly available.
Meanwhile, if someone hears that snorting a Vicodin gives a great buzz or that snorting a Xanax will make you perform better at your job; it is far easier for an interested party to get these substances from others. People may know a friend of a friend who has them available legally and is willing to sell a few. Perhaps they raid the medicine cabinet to see what is available. Regardless of where the person gets the substance from, the perception between the two are different. For most people “a doctor told someone else to take this, so how could it be unsafe”; in their mind that is all they really need to justify experimenting.
Addiction Does Not Simply Vanish
When we think about drug addiction, oftentimes we think about those people down on their luck. We assume that people who use illicit substances are those people we would not normally associate with anyway. However, opioid painkillers and other substances make it clear that people from all socioeconomic categories are prone to addiction. It is a problem that crosses all boundaries and does not care how well educated someone is or what their current net worth is.
What We Can Do
The first step should be limiting access to certain types of medication. There is no medical justification for a person receiving OxyContin, after having their wisdom teeth removed and the same procedure warranting nothing more than ‘a larger dose of aspirin’ in Europe. It seems that doctors and pain specialists have failed to understand the addictive impact of these highly addictive pain relievers. The first step should be to reassess the risk/reward factor when it comes to prescribing these types of medication – these substances have a proven medical value, but are we missing the point? The CDC found that 20% of those medical professionals legally allowed to prescribe medication accounted for 80% of all prescriptions in the United States. This indicates that there is a portion of healthcare professionals who are clearly not following specific guidelines.
The second step would be to make it far more difficult to abuse actual doctor recommendations. That is exactly why states such as New York have introduced the ‘Internet System for Tracking Overprescribing‘, abbreviated to I-STOP. This is a real-time computer database in which both pharmacists and doctors can log every prescription for specific drugs. This law was passed to make sure that those people who are actively ‘doctor shopping’ are unable to receive multiple prescriptions or have it filled multiple times in different locations.
Educate the Public
According to statistics from the CDC, a little more than half of the people who abuse pain-relieving medication (55%) receive it from relatives or friends without having to pay anything. Amongst those reporting in, 11.4% of the people admitted to having paid people for medication before and 4.8% said they have simply taken them from relatives and friends without permission. Only 17% of people received these pain-relieving medications with a legal prescription from a doctor. Doctors need to be mindful whom they are giving specific types of substances to and for how long.
No Signs of Slowing Down
According to the latest statistics from the CDC, more than 12 million Americans used pain medication for nonmedical purposes in 2010. The ease with which these substances can be obtained, combined with their addictive potential, means that everyone involved in the equation has to be more careful. Family members and friends need to be aware of signs of dependence. It is important for friends and relatives to understand that giving or selling these medications to someone is not helping them, is in fact, illegal and could send someone on a downward spiral. Moreover, we need our prescribing physicians to understand that the initial, ‘pain relief without addiction’ promises from drugs such as OxyContin, were widely overstated. Until we manage to adjust as a whole, we can only expect the number of people struggling with dependence and the amount of fatal overdoses to increase.