Prescription drug abuse, defined as using any prescription medication in a way other than as directed by a health care provider, is a worldwide problem. The problem has reached epidemic proportions in the United States, however, where prescription drugs kill more people every year than car accidents. Just how bad has the prescription drug problem become though? Simply calling it an “epidemic” does little to give significance to the phenomenon. Understanding the magnitude of the problem is a critical first step in determining just how many resources need to devoted to a solution.
Perspective on Prescription Drug Abuse
To put the prescription drug problem into perspective, consider the fact that Americans consume more narcotic pain killers than any other group on the face of the planet. In fact, Americans utilize 99% of the worlds’ hydrocodone supply, 80% of its oxycodone supply, and 65% of its hydromorphone (Dilaudid) supply. More Americans have abused prescription drugs than have tried cocaine, heroin, and hallucinogens combined.
The problem is getting worse too. While major causes of preventable death (e.g. death from car accidents) have been on the decline in recent decades, deaths from prescription drug abuse have doubled in just ten years. It is estimated that 52 million Americans use prescription drugs for nonmedical reasons and 1 in every 6 teenagers has admitted to taking prescription drugs to get high or to change their mood. Only marijuana and alcohol are experimented with more often than prescription drugs by teenagers.
Every day, 50 Americans die as a result of overdosing on prescription pain killers, a number that has quadrupled since 2000. Overall, the cost of nonmedical use of prescription opioids costs the U.S. roughly $53 billion every year. The most sobering statistics of all, however, reveals that prescription opioid overdoses killed roughly 12,000 individuals in 2007, a number that dwarfs the roughly 2,000 killed due to heroin overdose.
The Major Offenders
Opioids (a.k.a. narcotic pain killers), like oxycodone and morphine, are the most-abused class of prescription drugs, partly because they are the most commonly prescribed of all drugs. Thirteen percent of all prescriptions written are for opioids, a figure exceeded only by the 17% of scripts written for antibiotics. Overall, the number of people abusing prescription narcotics in the U.S. is more than 5 million.
Opioids are followed closely in abuse by tranquilizers, a broad class of drugs that includes such things as Klonopin, Valium, Xanax, and phenobarbital. Tranquilizers produce effects similar to those of alcohol, a property that makes it extremely dangerous to mix the two. Tranquilizers are easier to overdose on than opioids, but cause fewer deaths simply because they are prescribed at less than half the rate of narcotic pain killers.
The other major class of prescription drugs that is frequently abused is stimulants. This class includes medications like Ritalin and Adderall. Roughly 1.1 million Americans abuse prescription stimulants.
How Prescription Drugs Are Obtained
There is a common misconception, two in fact, surrounding the way in which people procure prescription drugs for abuse. The first misconception is that doctors are directly prescribing the abused drugs to the patients who abuse them. In truth, only about 18% of cases of prescription drug abuse (roughly 1 in 5) involve doctors prescribing drugs directly to the individual abusing them. Most physicians are trained to screen for signs of abuse and employ strict protocols designed to reduce or eliminate the chances of missing prescription drug abuse in patients.
The other common misconception about prescription drug abuse is that the internet is somehow responsible for the surge in recent years. In fact, less than 1% of individuals purchase prescription drugs for abuse on the internet.
The real source of most abused drugs is friends and relatives. Almost 71% of individuals who abuse prescription drugs either get them free from a friend or relative (54%) or take them (~17%) without permission. In short, the real problem is right within our own medicine cabinets. Keeping close tabs on prescription drugs, disposing of them properly when we don’t intend to use them, and are the most important factors in reducing prescription drug abuse.
Who Is at Risk?
The simple answer is that everyone is at risk. According to the Substance Abuse and Mental Health Services Administration, 26 million Americans have misused prescription drugs. Fully three million are aged 12-17, while 13 million are 50 years old or older. The states with the highest rates of abuse are Arkansas, Kentucky, Nevada, Oklahoma, Oregon, Tennessee, and Wisconsin.
Everyone is at risk of prescription drug abuse, but teens are particularly at risk because they fail to grasp the very real consequences of misusing prescription drugs. As it turns out, roughly 90% of all prescription drug abuse starts in the teenage years. It often beings with a prescription for a legitimate medical condition, is followed by using medication taken from friends and family, and ends with the use of illicit street drugs.
The problem starts well before teens are exposed to the prescription drugs though. It starts with perception of risk and careless prescribing habits, but extends back nearly two hundred years into humanity’s struggle to control pain and disease while avoiding the very real side effects of such endeavors. Who or what, exactly, is to blame for the current state of affairs?