The truth about prescription drug addiction is that it’s everyone’s problem. As we will see, it’s a societal issue with a complex cause. It won’t be solved quickly, or simply. But if you, or someone you love, is struggling with prescription drug abuse, you need to read this post.
Today, we’ll explore the prescription drug crisis in detail. We’ll discover just how it can ruin lives, and how it can cripple economies. You’ll learn which drugs are most commonly abused, and you’ll discover how governments are reacting to this crisis in new ways.
Along the way, we’ll explore the history of drug use and abuse to see if we can glean insights into why opioids are such an issue today.
We’ll end with a list of clear warning signs that addiction may be taking root, and we’ll cover clear, concise steps you can take to protect yourself from developing dependency. Let’s get started.
The Prescription Drug Crisis
Misuse of prescription CNS depressants, stimulants and opioids is a serious problem in the U.S., and, indeed, around the world. Addiction to opioids, in particular, is reaching national crisis levels. In fact, opioids are responsible for the majority of overdose deaths in the U.S. What’s more, anyone who uses an opioid is at risk of developing an addiction. This doesn’t mean that an individual is guaranteed to become addicted if they use an opioid, of course. But it does mean that no one is immune to the possibility.
The amount of time you use the opioid, your typical dose and your personal history all play a role in whether you’ll develop dependence.
As we’ll see, people have always been susceptible to developing a dependence on prescription drugs, and anyone, from any class or social strata, can be affected. Just because a substance isn’t a ‘street drug’ does not mean that it isn’t habit-forming. Nor does it mean that a person can’t become addicted to it.
You may experience cravings for opioids, even after one use. This is especially true of synthetic opioids, such as fentanyl.
In 2017, over 18-million people in the U.S. misused their prescriptions. That’s around five percent of individuals aged 12 and up. More than 2-million Americans abused prescription drugs for the first time in 2016. This according to the 2017 National Survey on Drug Use and Health. Averaged out, this equals 5,480 new abusers each day.
A perfect storm is brewing, and this isn’t mere hyperbole. The economic toll of the prescription drug abuse crisis could be staggering. The opioid crisis alone cost the U.S. $600-billion between 2015 and 2018.
According to the Centers for Disease Control, overdose deaths have more than tripled since 1999, meaning that drug overdoses now kill more people than car accidents or gun violence. Of course, this isn’t happening in isolation. The Type 2 Diabetes and obesity epidemics are occurring concurrently, and the overall financial burden to the economy could be massive.
The following prescription drugs are frequently abused.
- Fentanyl (Duragesic)
- Hydrocodone (Vicodin)
- Oxycodone (OxyContin)
- Oxymorphone (Darvon)
- Meperidine (Demerol)
- Morphine Sulfate
Central Nervous System (CNS) Depressants
- Diazepam (Valium)
- Alprazolam (Xanax)
- Zolpidem Tartrate (Ambien)
- Pentobarbital sodium (Nembutal)
- Sertraline (Zoloft)
- Dextroamphetamine (Dexedrine)
- Amphetamines (Adderall)
- Methylphenidate (Ritalin and Concerta)
The War on Drugs
The good news is that the opioid crisis is being recognized for what it is: an addiction crisis. It isn’t considered a problem that only a few struggle with. Perhaps for the first time, a major drug addiction crisis is viewed by the authorities as a legitimate public health crisis that threatens us all. What’s more, compared to earlier drug epidemics, the U.S. government is taking a downright therapeutic approach.
During the crack epidemic of the ‘80s, the so-called War on Drugs took a decidedly less therapeutic approach. The anti-drug initiative involved expansion of the role of law enforcement, which led to an explosion in prison population.
The more cynical among us might point to the fact that the opioid crisis affects Caucasians disproportionately—80 percent of overdose deaths in 2017—and infer that this is why it’s now a ‘crisis.’ Whatever the case, today it is well understood that addiction is a disease of the brain, and not a moral failing. Willpower alone is unlikely to see an addict through the dark tunnel of despair and into the light. Today, most experts agree that addicts are better served by intensive treatment and therapy, and not by jail time.
A Brief History of Drug Abuse
In this section, we’ll explore the history of prescription drug use, in particular, how these drugs have been abused by the public. This context is important, since without it, it’s possible to come to the conclusion that our drugs are merely becoming stronger, and therefore more addictive. While this may be the case in some circumstances, it’s not a major driving force.
Heroin arrives on the scene. At first, the drug was thought by experts to be non-habit forming. But it wasn’t long before its addictive potential was recognized. Doctors, legislatures and the public in general call for its ban.
Morphine, opium, heroin and cocaine are all in wide use in so-called ‘patent medicines.’ These were usually over-the-counter concoctions with little oversight.
Barbiturates were introduced. Doctors sing the praises of these sedatives because they were more effective and less toxic than bromides.
Bromides, which were highly addictive, were removed from medications by the end of WW2.
The United States enters into an international agreement to limit the spread of narcotics. The treaty is known as the Hague Opium Convention.
The Harrison Act introduces taxes on narcotics as a means to discourage their sale and use. The Treasury Department appoints the first ever narcotics agents.
In a landmark case, United States v. Doremus, the U.S. federal government establishes that it can regulate the dispensing of medicines.
As the U.S. enforces the Harrison act, illegal smuggling, sales and distribution of narcotics increases.
Prohibition begins in the U.S. Doctors are given permission to write prescriptions for whiskey or wine in special circumstances. This results in millions of prescriptions being written and is the first example in history of patients engaging in ‘doctor hopping’ to get access to a restricted substance.
The U.S. forms the Federal Bureau of Narcotics.
The repeal of prohibition in the U.S. Organized crime outfits shift from the production and distribution of alcohol to the sale of narcotics.
The introduction of the Marijuana Tax Act, which brought marijuana under federal control.
The abuse of non-narcotic medications comes under the purview of the FDA.
As we can see, wide swaths of the public have always struggled with addiction. Both medications and drugs can cause issues in society that require government intervention.
Addiction Knows No Color—But Treatment Does
Addiction is a disease of the brain, and it has no racial, gender or socio-economic bias. It is an equal opportunity condition. However, the way in which society deals with prescription drug addiction treatment does have a bias based on socioeconomic status. For instance, in New York, where the opioid crisis has hit particularly hard, hundreds of addicts receive methadone every day. This treatment regimen helps keep cravings under control and can keep people off the streets—looking for heroin—but it means that folks have to make the trip to a clinic every day.
Some people spend 45 minutes per day just traveling to and from a clinic, in fact.
But more well off folks receive exclusive treatments of buprenorphine. The difference between buprenorphine and methadone is that patients can pick the former up at a doctor’s office and then use it from the comfort of their own home. This is because buprenorphine was engineered to be safer in the event of accidental overdose.
Preventing Prescription Drug Addiction
The best line of defense against prescription drug addiction is to use these compounds only as directed by a medical professional. In the case of opioids, you should conduct a simple risk vs reward analysis. Is the potential risk of addiction worth the reduction in acute pain? This is a very individual assessment, and there’s no objective right or wrong answer here.
Manufacturers, physicians, pharmacists and patients can all play a role in preventing prescription drug abuse. In this section, we’ll explore several ways each link in the chain can do their part.
Drug companies and manufacturers are hard at work creating new types of opioid medications. These newer formulations are broadly known as abuse-deterrent medications. These new medications have safeguards built into them that discourage people from snorting or inhaling them. Manufacturers are also developing new drug delivery systems that prevent crushing, grinding or dissolving. These may include antagonist systems that deactivate the drug if tampering is detected.
In 2016, more than 84 percent of Americans had contact with a health care professional. This access places doctors in a unique position to suss out non-medical use of prescription drugs. By asking the patient to be forthcoming about all drug use, physicians may be able to provide information about treatment options.
Additionally, screening tools for the detection of non-medical use of ℞ drugs may be integrated into routine medical examinations. This would allow physicians to refer patients to appropriate treatment outlets.
Remember our timeline from earlier? When prohibition cut off the legal supply of alcohol, doctors saw a massive spike in prescription requests for whiskey and wine. The same is happening today. Consequently, physicians should be on the lookout for folks who hop from doctor to doctor in hopes of receiving opioid scripts. This is known as ‘doctor hopping,’ or ‘doctor shopping.’ Frequent, unscheduled refill requests are also a red flag.
Prescription drug monitoring programs, known as PDMPs, run at the state or federal level and keep track of prescriptions issued and filled. These databases can play an important role in limiting the access of opioids and other addictive substances.
Pharmacists play a crucial role in helping patients understand how often to take a medication. But they can also help patients understand warning signs of dependency. Additionally, when it comes to prescriptions themselves, pharmacists should remain vigilant for falsification or alteration. Recently, pharmacies have begun working together to combat the problem by alerting one another when they detect fraudulent prescriptions.
You can reduce your risk of developing a dependency on any prescription drug by following a few guidelines:
- Follow the instructions on the label or as described by a pharmacist exactly
- Keep in mind potential interactions with other drugs, such as alcohol
- Never change your dosing regimen without first consulting a doctor
- Never use another person’s prescription
In addition, you can help curtail the current opioid crisis:
- Never give your prescription medication to someone else
- Store your medications securely
Prescription drug addiction is a societal problem and will be solved on a broad scale, involving the participation of many people.
When to Seek Help
If you always use your prescription drugs as directed, your risk of developing a dependency is relatively low. However, if you find yourself disregarding the instructions—or using another person’s prescription—you are at higher risk. If you think you may have a problem with prescription drug abuse, please don’t hesitate to explore treatment options. The best time to start treatment is now. Addiction can quickly become a vicious cycle.
There are several warning signs that addiction may be taking root. In this section, we’ll explore a few of these. Be warned: it may not be easy to take a cold, hard look at your current situation. But gaining a more objective vantage point is the first step toward recovery.
Loss of Income
Where there is an addiction, there is usually money going out the window.
Check your budget. Have you moved money from one category to another in order to fund a drug habit, even if your drug of choice is a prescription?
Eventually, the cost of an addiction tends to surpass available funds.
In a similar vein, have you been missing work? As addiction takes hold, it’s common for folks to miss work, often for several days at a time.
Loss of Home or Friends
Have you had any major changes in living conditions? Have you been kicked out? Have people—people you believed to be good friends—cut ties with you?
As addiction sets in, it’s common for folks to look up and realize they’re suddenly quite alone. Often, people find ways to justify this. But too often, the addiction, and the behaviors that go along with it, are the root cause.
Loss of Life
Someone struggling with addiction may find it difficult to care for those who are dependent on them. The media is rife with stories of neglect or drunk driving, but the effect can be more subtle. If you have pets, are they as well-fed and as happy as they once were? Take stock of those who depend on you, human or animal. How is your goldfish doing?
The rate of drug-related emergency room visits is increasing. Many of these visits occur in the weeks or months following the onset of addiction, as the individual struggles to maintain balance in their day to day life. Severe cases, stemming from malnutrition or infection, can result in hospitalizations.
The truth about prescription drug addiction is that it’s a complex, harrowing phenomenon that we will all have to work together to tackle. But if you’re struggling with addiction, your number one priority should be to seek treatment. Addiction is a long-term condition, but it’s one that you can overcome, if you put the work in and get help at a treatment facility like The Hills. You needn’t feel powerless. If you’re trying to get addiction treatment for yourself or for someone you love, reach out to The Hills for comprehensive and caring treatment that will help patients detox and learn the skills to cope with their triggers and their addiction. You have options, let The Hills be one of them.