Physicians and the Prescription Drug Epidemic
> 3/15/2006 9:19:30 AM

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

Perhaps most worrisome though is the fact that it is the youngest Americans who are at the greatest risk. Almost half of all prescription drug abuse is by those aged 12 to 25. 10% of 12th graders reported using amphetamines like Ritalin and Benzedrine without having been prescribed them in 2004. Non-medical use of opioids, tranquilizers and sedatives has also been on the rise in this age group. Harmful behavior patterns are being established earlier, and when combined with alcohol and other drugs, these prescription medicines are creating a deadly situation.

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

The number of abusers cited above has grown 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 dangerous, but can be highly addictive as well. 

Often thought of as less dangerous than other illicit drugs, prescription medications have grown into a full-fledged abuse epidemic all their own. The problem comes in large part from the fact that the public is flooded with information about every new "miracle" drug. Doctors, who are often under-informed, either prescribe recklessly or are duped by patients that travel from one M.D.'s office to the next looking to pick up scripts. Fraudulent prescriptions and pharmacy robbery also help to get these drugs onto the streets. 

While the latter is certainly a law enforcement matter, a large 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. Many times a patient's drug addiction starts as a regularly 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 patient to ignore directions and acquire an addiction.  If not confronted by the doctor, this patient will continue to look for a way to meet their cravings, either faking symptoms or changing doctors if necessary. 

Studies have shown that many GPs are afraid to address the subject of prescription drug abuse with their patients. If change is going to come in this situation, it must start with the doctors. By putting these powerful drugs on the streets, they risk the lives of their patients and anyone else who might have access to the prescriptions. Regulation needs to come from those in the medical profession. But the word must also be spread to patients that prescription drug abuse is not harmless. Their rationalized belief, mentioned by many sufferers, that because the drugs came with a prescription, they are safe. This type of thinking is na´ve and can lead to disaster. 

The gloves need to come off regarding physician prescribing of addictive drugs. In states like New York, the "triplicate" mandate that all class II drugs need to be monitored by the state drastically reduced the presciptions of these drugs. These types of initiatives are effective, but do not address the whole problem. A better method would be for hospitals and physicians to be able to report anonymously a patient who is iatrogenically addicted and the physician or physicians involved in this outcome to a friendly agency. The reporting agency then could contact the physician and progressively educate without punitive action. Repeat offenders would need to have progressively more aggressive interventions. The behavior of physicians would change in a hurry if peer review called their treatments into question.

Use the link below to watch me discuss this problem in a vlog presentation.

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