Prescription Drug Addiction Treatment

According to a recent survey, almost 50 million Americans, ages 12 and older, have abused prescription drugs in their life. That means over 1 in 6 citizens has taken a prescription drug for non-medical, recreational purposes.

    Perhaps most burdensome though is the fact that it is the youngest individuals who are at the greatest risk. Nearly half of all prescription substance abuse is by those aged 12 to 25. 10% of 12th graders admitted consuming amphetamines like Ritalin and Benzedrine without having been prescribed them in 2004. Non-medical use of opiates, tranquilizers and sedatives has also been increasing in this age group. Harmful behavior patterns are being established earlier, and when combined with alcohol and other substances, these prescription medicines are creating a fatal situation.

    This widespread of prescription drug abuse is the new tune on college campuses of an old song that goes like this.....students prescribed substances from physicians for ADHD share their scripts for recreational purposes like drinking games and longevity for all night binge drinking. Pain medicines such as Vicoden or even OxyContin find their way into an opiate haze of partying that is considered safer than using harder drugs like heroin or methamphetamine. The improbable substance dealer in all of this is the local M.D.

    This amount of abusers has been increasing dramatically over the last several decades, with pain relievers accounting for a majority of the use. Codeine, Demerol, Percocet, Vicodin and Oxycontin are all examples of pain medications that are not only hazardous, but can be extremely addictive as well.

    Frequently thought of as less dangerous than other illegal drugs, prescription medications have grown into a full fledge abuse epidemic all their own. The issue is that the public is flooded with data about every new miracle drug. Then doctors, who are frequently under-informed, either prescribe dangerously or are duped by patients that travel from one M.D.¹s office to the next looking to pick up scripts. Fraudulent prescriptions and drugstore robbery also help to get these substances onto the streets.

    While the final is undoubtedly a law enforcement matter, a wide portion of prescription drug abuse could be stopped if doctors simply learned to recognize and talk with their patients about prescription drug abuse, and stop letting their patients treat them like a street pusher. Several times a patient¹s drug addiction starts as a constantly prescribed painkiller, to deal with a broken leg perhaps or a prescription for attention problems or for panic anxiety. But unregulated by a physician, it is easy for the individual to ignore directions and become addicted. If not confronted by the doctor, this patient will still look for a way to meet their cravings, either faking symptoms, or changing doctors if needed.

    Studies have demonstrated that several GPs are afraid to address the subject of prescription drug abuse with their patients. If change is going to occur in this situation, it must start with the physicians. When Physicians put these powerful substances on the streets, they risk the lives of their patients and anybody else that might have access to the prescriptions. Regulation needs to originate from those in the medical profession; the word must be displayed to patients. Some believe that prescription substance abuse is not harmless, this rationalized belief, originated by many patients, because the drugs came with a prescription, so they assume it is safe. This way of thinking is naïve and can lead to catastrophe.

    The gloves need to come off concerning doctors prescribing addictive drugs. In States like New York, the "triplicate" mandates all class II substances need to be monitored by the State, drastically decreasing the prescriptions of these drugs. These types of initiatives are efficient but do not address the whole issue. A better way would be for hospitals and physicians to be able to report anonymously a patient who is addicted by something that they prescribed and the doctor(s) involved in this outcome to a friendly agency. The reporting agency then could contact the physician and increasingly educate without punitive action, however repeat offenders would need to have progressively more aggressive interventions.

Highlights of CASA Surveys of Physicians and Pharmacists on Diversion and Abuse of Controlled Prescription Drugs

Physician Survey Highlights
  • 43.3 percent of doctors do not ask about prescription substance abuse when taking a patient’s health history.
  • 33 percent do not regularly call or get records from the patient's previous (or other treating) physician before prescribing controlled substances on a long-term basis.
  • 47.1 percent mention that patients frequently try to pressure them into prescribing a controlled drug.
  • 74.1 percent have abstained from prescribing controlled substances during the past 12 months because of concern that a patient might become addicted to them.
  • 59.1 percent believe that patients account for the bulk of the diversion issue.
  • Physicians perceive the three main mechanisms of diversion to be doctor shopping (when patients obtain controlled substances from multiple doctors) (96.4 percent), patient deception or manipulation of doctors (87.8 percent), and forged or altered prescriptions (69.4 percent).
  • Only 19.1 percent received any medical school training in identifying prescription drug diversion; only 39.6 percent received any training in medical school in distinguishing prescription drug abuse and addiction.

Pharmacist Survey Highlights
  • 28.4 percent do not validate on a regular basis the prescribing physician’s DEA number when dispensing controlled substances; one in 10 (10.5 percent) rarely or never do so.
  • 61 percent do not regularly ask if the patient is taking any other controlled substances when dispensing a controlled medication; 25.8 percent rarely or never do so.
  • When a patient presents a prescription for a controlled drug, 26.5 percent “somewhat or very frequently” think it is for purposes of diversion or abuse; 78.4 percent become “somewhat or very” concerned about diversion or abuse when a patient asks for a controlled substance by its brand name.
  • 83.1 percent have refused to give a controlled drug in the past year because of suspicions of diversion or abuse; 51.8 percent believe that patients account for the bulk of the diversion issue.
  • 28.9 percent have experienced a theft or robbery of controlled drugs at their drug store within the last five years; 20.9 percent do not stock certain controlled drugs in order to prevent diversion.
  • Only near half received any training in distinguishing prescription drug diversion (48.1 percent) or abuse or addiction (49.6 percent) since pharmacy school.

CASA surveyed 979 physicians and 1,030 pharmacists from July 21 to October 31, 2004. The margin of error is +/-3%.

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